Active NPI
Michael Thomas Smalley, LVN
- Licensed Vocational Nurse
- Fort Irwin, CA
National Provider Identifier
1730212804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 207511
- Practice address
- Weed Army Community Hospital
BLDG 166
Fort Irwin, CA 92310 - Phone
- (760) 380-7391
- NPI assigned
- Mar 14, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 207511 | TX | Primary |
Addresses
Primary practice location
Weed Army Community Hospital
BLDG 166
Fort Irwin, CA 92310
Mailing address
25862 Jasper Rd Apt 21
Barstow, CA 92311-7203
Phone (909) 904-0079
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 207511 | Other | TX | LICENSED VOCATIONAL NURSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 207511 | TX | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730212804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25862 JASPER RD APT 21",
"city": "BARSTOW",
"state": "CA",
"postal_code": "923117203",
"telephone_number": "909-904-0079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "WEED ARMY COMMUNITY HOSPITAL",
"address_2": "BLDG 166",
"city": "FORT IRWIN",
"state": "CA",
"postal_code": "92310",
"telephone_number": "760-380-7391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMALLEY",
"first_name": "MICHAEL",
"middle_name": "THOMAS",
"name_prefix": "Mr.",
"credential": "LVN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "TX",
"license": "207511",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED VOCATIONAL NURSE",
"identifier": "207511",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Irwin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.