Lisa J Smith, RN,MSN,NP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

R3N29 Issued in MO

Practice address

17300 N. Outer 40
Ste 100
Chesterfield, MO 63005

Phone

(636) 519-8889

NPI assigned

May 3, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760694954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18926 WILDHORSE CREEK",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "63005",
            "telephone_number": "636-519-4084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17300 N. OUTER 40",
            "address_2": "STE 100",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63005",
            "telephone_number": "636-519-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LISA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "RN,MSN,NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MO",
            "license": "R3N29",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE NUMBER",
            "identifier": "104229",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy M Smiley, CCC-SLP
• Claire Elizabeth Smith, BCBA
• Curtis J Smith, DPT
• Katherine Smith, PLPC
• Kevin B. Smith, M.D.
• Matthew Vernon Smith, MD
• Melanie Maria Smith, LPC
• Michelle L Smith, DC
• Rhoda Smith
• Stephen G Smith, MD

• Ambulatory Surgical Clinic/Center in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Ambulatory Surgical Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.