Tyrone Smith

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95015797 Issued in CA

Practice address

50249 Cesar Chavez St Ste K
Coachella, CA 92236-1530

Phone

(760) 393-0555

Fax

(760) 393-0522

NPI assigned

Mar 14, 2019

Last updated

Dec 31, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tyrone.smity.p1@direct.cdsdp.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clinicas de Salud del Pueblo, Inc

  dba Innercare

  • Federally Qualified Health Center (FQHC)
  • El Centro, CA
  • NPI 1346313889
  Medicare reassignment NPD
• Personal Recovery Network LLC

  dba LifeStance Health

  • Psychiatry Physician
  • Stockbridge, GA
  • NPI 1881990869
  Medicare reassignment NPD
• Clinicas de Salud del Pueblo Inc.

  dba InnerCare Pharmacy

  • Community/Retail Pharmacy
  • El Centro, CA
  • NPI 1962045872
  NPD
• Clinicas de Salud del Pueblo, Inc

  dba Indio Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Indio, CA
  • NPI 1093138430
  NPD

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

{
    "created_epoch": "1552521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640908800000",
    "number": "1548729080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50249 CESAR CHAVEZ ST STE K",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "922361530",
            "telephone_number": "760-393-0555",
            "fax_number": "760-393-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50249 CESAR CHAVEZ ST STE K",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "922361530",
            "telephone_number": "760-393-0555",
            "fax_number": "760-393-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TYRONE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-14",
        "last_updated": "2021-12-31",
        "certification_date": "2021-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95015797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miguel Serratos, RADT
• Febey Shokralla
• Joanna Campos Silva
• Maribel Silva, MA
• Serly Simonian
• Catherine Maria Solares Carroll, M.D.
• Sandra V Solorio
• Sooho Joe,DDS,Inc
• Jaime M Soria, LMFT
• Stephen B. Lee Medical Corporation at Coachella (Clinica Medica Del Valle, Inc.)

• Psychiatric/Mental Health Nurse Practitioner in Coachella, CA
• Providers in Coachella, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.