Active NPI
Carrie Smith, RN
- Registered Nurse
- Kenova, WV
National Provider Identifier
1780399303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 1177305
- Practice address
- 820 Poplar St
Kenova, WV 25530-1530 - Phone
- (304) 453-4992
- Fax
- (304) 453-5574
- NPI assigned
- Jan 18, 2023
- Last updated
- Jan 18, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1177305 | KY | Primary |
Addresses
Primary practice location
820 Poplar St
Kenova, WV 25530-1530
Mailing address
820 Poplar St
Kenova, WV 25530-1530
Phone (304) 453-4992
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Carrie.Smith@modivcare.com | Health Information Exchange (HIE) | |
| Direct Messaging Address | carrie.smith@modivcare.com | Direct |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1177305 | KY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674000000000",
"number": "1780399303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 POPLAR ST",
"city": "KENOVA",
"state": "WV",
"postal_code": "255301530",
"telephone_number": "304-453-4992",
"fax_number": "304-453-5574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 POPLAR ST",
"city": "KENOVA",
"state": "WV",
"postal_code": "255301530",
"telephone_number": "304-453-4992",
"fax_number": "304-453-5574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "CARRIE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-18",
"last_updated": "2023-01-18",
"certification_date": "2023-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "KY",
"license": "1177305",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Carrie.Smith@modivcare.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "820 Poplar St",
"city": "Kenova",
"state": "WV",
"country_code": "US",
"postal_code": "255301530",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "carrie.smith@modivcare.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "820 Poplar St",
"city": "Kenova",
"state": "WV",
"country_code": "US",
"postal_code": "255301530",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Kenova, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.