Aaron Smith & Sophia Kibuismith

Key facts

NPI

1649045808

Entity type

Organization (NPI type 2)

Primary specialty

Adult Care Home Facility 311ZA0620X

Legal business name

AARON SMITH & SOPHIA KIBUISMITH

Practice address

4811 5TH Ave S
Saint Petersburg, FL 33711-1421

Phone

(650) 440-0022

NPI assigned

Nov 17, 2023

Organization subpart

No

Authorized official

Name

Aaron Smith NPI 1568142537

Title

Owner

Phone

(650) 440-0022

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Aaron J Smith Adult Care Home Facility · St Petersburg, FL · NPI 1568142537
  NPD Authorized official ADULT CARE HOME

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 17, 2023.

{
    "created_epoch": "1700179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1649045808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4811 5TH AVE S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337111421",
            "telephone_number": "650-440-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4811 5TH AVE S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337111421",
            "telephone_number": "650-440-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AARON SMITH & SOPHIA KIBUISMITH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-17",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-440-0022"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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