Melinda Elise Smith, L.M.T. , M.M.P

Primary specialty

SpecialistTaxonomy code 174400000X

License

MT209000676 Issued in IN

Practice address

5812 Maplecrest Rd
Fort Wayne, IN 46835-3840

Phone

(260) 969-7977

Fax

(260) 969-6590

NPI assigned

Sep 27, 2014

Last updated

Sep 27, 2014By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1411776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411776000000",
    "number": "1598168197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4821 FOXGROVE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468182029",
            "telephone_number": "260-246-9963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5812 MAPLECREST RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468353840",
            "telephone_number": "260-969-7977",
            "fax_number": "260-969-6590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MELINDA",
        "middle_name": "ELISE",
        "name_prefix": "Mrs.",
        "credential": "L.M.T. , M.M.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-27",
        "last_updated": "2014-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "MT209000676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE THERAPY LICENSE NUMBER",
            "identifier": "MT209000676",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly K Smith, M ED
• Kimberly Ruth Smith, DVM
• Linda C Smith, LMFT LMHC
• Lisa Ann Smith, MSN, RN, AGCNS, NP-C
• Mareah Smith, RBT
• Melissa Nicole Smith, MSN, FNP
• Micah W Smith, MD
• Nathan S Smith, MD
• Paris Nicole Smith, PHARMD
• Sandra Smith

• Specialist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2014; 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.