Active NPI
Amanda K Smith
- Peer Specialist
- Watson, OK
National Provider Identifier
1740933852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 6336 Buffalo Rd
Watson, OK 74963-5145 - Phone
- (817) 298-7460
- NPI assigned
- Jan 28, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
6336 Buffalo Rd
Watson, OK 74963-5145
Mailing address
6336 Buffalo Rd
Watson, OK 74963-5145
Phone (817) 298-7460
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| N084156956 | Other | OK | DL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | WATSON |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643328000000",
"number": "1740933852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6336 BUFFALO RD",
"city": "WATSON",
"state": "OK",
"postal_code": "749635145",
"telephone_number": "817-298-7460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6336 BUFFALO RD",
"city": "WATSON",
"state": "OK",
"postal_code": "749635145",
"telephone_number": "817-298-7460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "AMANDA",
"middle_name": "K",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-28",
"last_updated": "2022-01-28",
"certification_date": "2022-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DL",
"identifier": "N084156956",
"state": "OK"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "WATSON",
"affiliation": "N",
"address_1": "6336 Buffalo Rd",
"city": "Watson",
"state": "OK",
"country_code": "US",
"postal_code": "749635145",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.