Decker Wood Smith

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

365767 Issued in CA

Practice address

499 Humboldt St Ste 104
Santa Rosa, CA 95404-4214

Phone

(707) 565-7418

NPI assigned

Jan 23, 2007

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• County of Sonoma

  • Community Health Clinic/Center
  • Santa Rosa, CA
  • NPI 1699825067
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408924800000",
    "number": "1598810442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 HUMBOLDT ST STE 104",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 HUMBOLDT ST STE 104",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044214",
            "telephone_number": "707-565-7418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DECKER",
        "middle_name": "WOOD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2014-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "365767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Smith
• Casey Josephine Smith, AU.D.
• Daniel P. Smith
• David Lyman Smith, M.D.
• David Michael Smith
• Douglas Kent Smith, PH.D.
• Elizabeth Ashley Smith, OTR/L, C/NDT
• Elizabeth Jane Smith, MA
• Elizabeth Pointer Smith, CNM
• Jacqueline Smith, LCSW

• Registered Nurse in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.