Carol Smith, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

400063 Issued in NY

Practice address

505 Main St
Northport, NY 11768-1954

Phone

(631) 261-7200

NPI assigned

Dec 15, 2006

Last updated

Oct 2, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1790847721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 MAIN ST",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117681954",
            "telephone_number": "631-261-7200",
            "fax_number": "631-261-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 MAIN ST",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117681954",
            "telephone_number": "631-261-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CAROL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "400063",
            "primary": true
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "NY",
            "license": "M204235",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mandeep Singh, M.D
• Amalia Rose Sirica, LCSW
• Michael B Sklar, NP
• Cheyenne Slack, LPN
• Richard David Sloan, MS, P.DIPL., CRC
• Kimberly Ann Smith, PHARM.D.
• Ralph Kurt Smith, MS ED. CRC
• Melissa Snyder, LCSW
• Amanda Ilana Sokolowski, LCSW
• Joseph John Sorrento, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Northport, NY
• Providers in Northport, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; 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.