Active NPI
Deborah Jane Smith, LD
- Registered Dietitian
- Silver City, NM
National Provider Identifier
1629371034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD-0803
- Practice address
- 1007 N Pope St
Silver City, NM 88061-5161 - Phone
- (575) 388-1511
- Fax
- (575) 388-3465
- NPI assigned
- Dec 8, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD-0803 | NM | Primary |
Addresses
Primary practice location
1007 N Pope St
Silver City, NM 88061-5161
Mailing address
530 Demoss Street
Lordsburg, NM 88045-2618
Phone (575) 542-8384
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NMAAA0103 | Other | MEDICARE PTAN | |
| 98633708 | Medicaid | NM |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD-0803 | NM | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409616000000",
"number": "1629371034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 DEMOSS STREET",
"city": "LORDSBURG",
"state": "NM",
"postal_code": "880452618",
"telephone_number": "575-542-8384",
"fax_number": "575-542-8367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1007 N POPE ST",
"city": "SILVER CITY",
"state": "NM",
"postal_code": "880615161",
"telephone_number": "575-388-1511",
"fax_number": "575-388-3465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "DEBORAH",
"middle_name": "JANE",
"credential": "LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-08",
"last_updated": "2014-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NM",
"license": "LD-0803",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "NMAAA0103",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "98633708",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Silver City, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.