Makenna Jean Smith

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

940 N Center Ave
Gaylord, MI 49735-9318

Phone

(844) 244-1818

NPI assigned

Mar 15, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1528643194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S DOUGLAS RD STE 230",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344108",
            "telephone_number": "305-846-9807",
            "fax_number": "305-846-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 N CENTER AVE",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497359318",
            "telephone_number": "844-244-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MAKENNA",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "S530578385699",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffery E Sloniker, CRNA
• Chloe Elaine Smith, BEHAVIOR TECHNICIAN
• Isaac Kelly Smith
• Jamie Smith
• Kevin M Smith, D.O.
• Olivia Rae- Ann Smith, BEHAVIOR TECHNICIAN
• Rachel Lynn Smith, REGISTERED NURSE
• Shelby Smith, MA, LPC
• Taylor Angel Smith
• Olivia Solowy

• Behavior Technician in Gaylord, MI
• Providers in Gaylord, MI by specialty
• Behavior Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.