Amanda Nicole Smith

Primary specialty

SpecialistTaxonomy code 174400000X

License

692607121 Issued in NY

Practice address

116 Marian Dr
Syracuse, NY 13219-2423

Phone

(315) 569-8872

NPI assigned

Aug 10, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1740734565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MARIAN DR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132192423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MARIAN DR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132192423",
            "telephone_number": "315-569-8872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMANDA",
        "middle_name": "NICOLE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "692607121",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "692608121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Michael Smiedy, NP
• Smiles by Design Dental PC
• Katrina Elaina Smith Gretsky, AUD
• Pamela R Smith Lotito
• Alexandria Smith-Hannah, M.D.
• Ann Marie Smith, LCSW
• Barbara A. Smith
• Beverly D Smith, M.D.
• Bradley Smith, CASAC II
• Cherylanne Smith, RN

• Specialist in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; 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.