Individual provider Active NPI

Tony Smith Jr.

  • Home Health Aide
  • Detroit, MI
National Provider Identifier
1780550491
Registry record updated Oct 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
S530799014521 Issued in MI
Practice address
11303 Vaughan St
Detroit, MI 48228-1333
Phone
(313) 282-5004
NPI assigned
Oct 11, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X S530799014521 MI Primary

Addresses

Primary practice location

11303 Vaughan St
Detroit, MI 48228-1333

Mailing address

11303 Vaughan St
Detroit, MI 48228-1333
Phone (313) 282-5004

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

State licenses

LicenseStateTypeSpecialty
S530799014521MIMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1760140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760140800000",
    "number": "1780550491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11303 VAUGHAN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482281333",
            "telephone_number": "313-282-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11303 VAUGHAN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482281333",
            "telephone_number": "313-282-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TONY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-11",
        "last_updated": "2025-10-11",
        "certification_date": "2025-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "MI",
            "license": "S530799014521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2025; 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.