Tracie Michele Smith, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

4704194204 Issued in MI

Practice address

1200 N Telegraph Rd # 32E
Pontiac, MI 48341-1032

Phone

(800) 231-1127

NPI assigned

Sep 28, 2023

Last updated

Sep 28, 2023By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1619756657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27495 FRANKLIN RD APT 208",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480348274",
            "telephone_number": "248-234-2679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N TELEGRAPH RD # 32E",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411032",
            "telephone_number": "800-231-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TRACIE",
        "middle_name": "MICHELE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704194204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Jane Smith, MD
• Kelisha Smith
• Lauren Margaret Smith
• Michael Sean Smith, RN
• Sarah Smith, DPT
• Stacie Snadon-Ford, RN
• Joseph Sneij, MD
• Ashley Marie Snowden, MA, TLLP
• Melanie Barbara Snyder-Lindblom, LMSW
• Adam Jozef Sobilo, MD

• Psychiatric/Mental Health Registered Nurse in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Psychiatric/Mental Health Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.