Individual provider Active NPI

Jay'Ana Smith

  • Licensed Practical Nurse
  • Rochester, NY
National Provider Identifier
1609237544
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
10 325006 Issued in NY
Practice address
147 Penhurst St
Rochester, NY 14619-1519
Phone
(585) 713-0910
NPI assigned
Mar 18, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 10 325006 NY Primary

Addresses

Primary practice location

147 Penhurst St
Rochester, NY 14619-1519

Mailing address

230 Opal Dr
Roswell, GA 30075-3730
Phone (470) 557-5971

Other practice location 1

230 Opal Dr
Roswell, GA 30075-3730
Phone (470) 557-5971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10 325006NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Inspired by Jayana CurrentSince Jul 9, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1609237544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 OPAL DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300753730",
            "telephone_number": "470-557-5971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 PENHURST ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146191519",
            "telephone_number": "585-713-0910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 Opal Dr",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300753730",
            "country_code": "US",
            "telephone_number": "470-557-5971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JAY'ANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-18",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "10 325006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.