Amy Smith, MS, CNS, LDN, BCHN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DX5177 Issued in MD

Practice address

10451 Mill Run Cir Ste 400
Owings Mills, MD 21117-5594

Phone

(276) 475-8848

Fax

(276) 222-6916

NPI assigned

May 6, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 8

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Master of Science

State licenses

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1740801232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 WYNDALE RD",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242104721",
            "telephone_number": "423-863-3072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10451 MILL RUN CIR STE 400",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175594",
            "telephone_number": "276-475-8848",
            "fax_number": "276-222-6916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "553 Wyndale Rd",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242104721",
            "country_code": "US",
            "telephone_number": "423-863-3072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMY",
        "credential": "MS, CNS, LDN, BCHN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-06",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "DE",
            "license": "DN-0010852",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "DX5177",
            "primary": true
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MD",
            "license": "DX5177",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "VA",
            "license": "CNS18228",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "IL",
            "license": "164.00899",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "DE",
            "license": "DN-0010852",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.00899",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://soulsticenutrition.practicebetter.io/#/p/home",
            "affiliation": "N",
            "address_1": "851 French Moore Jr Blvd Ste 135",
            "city": "Abingdon",
            "state": "VA",
            "country_code": "US",
            "postal_code": "242104706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://soulsticenutrition.practicebetter.io/#/p/home",
            "affiliation": "N",
            "address_1": "553 Wyndale Rd",
            "city": "Abingdon",
            "state": "VA",
            "country_code": "US",
            "postal_code": "24210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Smile Forever Dentistry
• Smiledmd of Maryland, LLC
• Tatiana G Smirnova, CRNP
• Amber Dasia Smith, DC
• Amie Smith
• Ashley Smith
• Destiny Smith, RBT
• Julia K Smith, CRNP
• Kevin J Smith, LGPC, CAC-AD, M.S.
• Michael Robert Smith Jr., D.P.M.

• Registered Dietitian in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Registered Dietitian in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.