Individual provider Active NPI

Adam Smith, PRSS

  • Peer Specialist
  • Beckley, WV
National Provider Identifier
1710783220
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
23-9176 Issued in WV
Practice address
311 Prince St
Beckley, WV 25801-4515
Phone
(865) 456-0478
NPI assigned
Feb 24, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 175T00000X 23-9176 WV Primary

Addresses

Primary practice location

311 Prince St
Beckley, WV 25801-4515

Mailing address

311 Prince St
Beckley, WV 25801-4515
Phone (865) 456-0478

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
23-9176WVMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Winds of Change Recovery and Mental Health LLC Single Specialty CurrentSince Mar 11, 2025 Accepting new patients

Locations

311 Prince St
Beckley, WV 25801
Phone (304) 953-3987

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": "1740355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1710783220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 PRINCE ST",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014515",
            "telephone_number": "865-456-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 PRINCE ST",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014515",
            "telephone_number": "865-456-0478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ADAM",
        "credential": "PRSS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": "WV",
            "license": "23-9176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.