Individual provider Active NPI

Summer Smith

  • Registered Dietitian
  • Dandridge, TN
National Provider Identifier
1790456556
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86018803 Issued in CA
Practice address
3250 Proffitt Heights Cir
Dandridge, TN 37725-7308
Phone
(909) 838-8134
NPI assigned
Sep 22, 2021
Last updated
Jan 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86018803 CA Primary

Addresses

Primary practice location

3250 Proffitt Heights Cir
Dandridge, TN 37725-7308

Mailing address

100 Tennessee St Apt 12
Redlands, CA 92373-4456
Phone (909) 838-8134

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
86018803CAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Cloud Health Medical Group of New Jersey, P.C. Past Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1790456556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TENNESSEE ST APT 12",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734456",
            "telephone_number": "909-838-8134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 PROFFITT HEIGHTS CIR",
            "city": "DANDRIDGE",
            "state": "TN",
            "postal_code": "377257308",
            "telephone_number": "909-838-8134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SUMMER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-22",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86018803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dandridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.