Individual provider Active NPI

Riley Jean Smith, LIMHP, LCSW

  • Mental Health Counselor
  • Grand Island, NE
National Provider Identifier
1730725201
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2002 Issued in NE
Practice address
2608 Old Fair Rd
Grand Island, NE 68803-5271
Phone
(308) 382-5297
Fax
(308) 382-5315
NPI assigned
Nov 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1736 NE
Mental Health Counselor 101YM0800X 2002 NE Primary

Addresses

Primary practice location

2608 Old Fair Rd
Grand Island, NE 68803-5271

Mailing address

2608 Old Fair Rd
Grand Island, NE 68803-5271
Phone (308) 382-5297

Other identifiers 1

IdentifierTypeStateIssuer
10025173100MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191204002134 NE Practitioner - Clinical Social Worker 5799118741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wholeness Healing Center PCGroup PAC ID 3173571320, 13 clinicians

Practice addresses (Care Compare)

2608 Old Fair Rd
Grand Island, NE 68803-5271
Phone 3083825297211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wholeness Healing Center PC Mental Health CurrentSince Nov 18, 2019 Accepting new patients

Locations

2608 Old Fair Rd
Grand Island, NE 68803
Phone (308) 382-5297

100 N 15th St
Ord, NE 68862
Phone (308) 728-5795

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": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1730725201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 OLD FAIR RD",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688035271",
            "telephone_number": "308-382-5297",
            "fax_number": "308-382-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 OLD FAIR RD",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688035271",
            "telephone_number": "308-382-5297",
            "fax_number": "308-382-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RILEY",
        "middle_name": "JEAN",
        "credential": "LIMHP, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-20",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1736",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "2002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025173100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.