Shetaye Smith, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

081002516RN Issued in OR

Practice address

6450 13TH Ave SE
Salem, OR 97306-1454

Phone

(503) 362-0373

Fax

(503) 362-0373

NPI assigned

Apr 25, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1790043081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18397",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973058397",
            "telephone_number": "503-910-5648",
            "fax_number": "503-362-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6450 13TH AVE SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973061454",
            "telephone_number": "503-362-0373",
            "fax_number": "503-362-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHETAYE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-25",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "081002516RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela P Smith, MD
• Robert Alexander Smith, QMHA
• Rodney Allen Smith, CADC II
• Sarah Catherine Smith, MSW
• Sean Marlow Smith, D.D.S.
• Sierra Lynn Smith, THW,PSS,CRM
• Simona Smith, LPC-A
• Stephanie A Smith, RDH
• Teresa Diane Smith, RDH
• Tina I Smith, PSS

• Registered Nurse in Salem, OR
• Providers in Salem, OR by specialty
• Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.