Individual provider Active NPI

Veronica Allegra Smith, PHD

  • Psychologist
  • Muncie, IN
National Provider Identifier
1750850558
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
99089849A Issued in IN
Practice address
1806 W Royale Dr
Muncie, IN 47304-2243
Phone
(765) 381-4578
NPI assigned
Nov 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 99089849A IN Primary

Addresses

Primary practice location

1806 W Royale Dr
Muncie, IN 47304-2243

Mailing address

2015 N Hollywood Ave
Muncie, IN 47304-2710
Phone (817) 881-6638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20191125001850 IN Practitioner - Clinical Psychologist 5395178792 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
99089849AINMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Health Services, Inc. Current Accepting new patients
Open Door Health Services, Inc. CurrentSince Nov 4, 2019 Accepting new patients
Open Door Health Services, Inc. CurrentSince Nov 4, 2019 Accepting new patients
Open Door Health Services, Inc. Past Accepting new patients

Locations

333 S Madison St
Muncie, IN 47305
Phone (765) 287-3087

Interoperability endpoints

  • Direct secure messaging: veronica.smith.1@10844.direct.athenahealth.com

Organizations & group practices 4

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": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1750850558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 N HOLLYWOOD AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473042710",
            "telephone_number": "817-881-6638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 W ROYALE DR",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473042243",
            "telephone_number": "765-381-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "VERONICA",
        "middle_name": "ALLEGRA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-21",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "99089849A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

Verify at the official NPI Registry.