Shad Jeffry Smith, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

1080 N Campbell Rd
Apt 4
Royal Oak, MI 48067-1533

Phone

(941) 527-7301

Fax

(313) 577-1012

NPI assigned

Dec 19, 2005

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

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216512000000",
    "number": "1619953973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 N CAMPBELL RD",
            "address_2": "APT. 4",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480671533",
            "telephone_number": "941-527-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 N CAMPBELL RD",
            "address_2": "APT 4",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480671533",
            "telephone_number": "941-527-7301",
            "fax_number": "313-577-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHAD",
        "middle_name": "JEFFRY",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2008-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marc Smith, MD
• Marie Smith
• Nina-Louise Amanda Smith, MSN, FNP-BC
• Princy Mathai Smith, NP
• Robert Smith, CRNA
• Shannon Smith, CRNA
• Shelly Lynn Smith, P.A.
• Sherry Ann Smith, PH.D., LLP
• Susan K Smith, RD
• Tyronnica Smith

• Athletic Trainer in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Athletic Trainer in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2008; 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.