Chester Cory Smith, PHD, NP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

901546 Issued in MS

Practice address

1509 Dulles Dr
Lafayette, LA 70506-3718

Phone

(337) 408-0815

Fax

(337) 991-9288

NPI assigned

Jun 14, 2016

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)

Enrolled

Credentials

Nurse Practitioner, Doctor of Philosophy

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1609226422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 BROAD AVE",
            "address_2": "STE 300A",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012404",
            "telephone_number": "228-575-2700",
            "fax_number": "228-575-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 DULLES DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705063718",
            "telephone_number": "337-408-0815",
            "fax_number": "337-991-9288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHESTER",
        "middle_name": "CORY",
        "credential": "PHD, NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-14",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MS",
            "license": "901546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie Gayle Smith, FNP
• Brent Lee Smith, ANP
• Brian Samuel Smith, MD
• Carolyn Yvonne Smith, MD
• Chelsea Smith
• Delisa Rae Smith, FNP
• Deondra Leigh Smith, LPC
• Devin Smith
• Elizabeth Renee Smith, M.D.
• Ethel Stackhouse Smith, M.D.

• Primary Care Nurse Practitioner in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Primary Care Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; 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.