Individual provider Active NPI

Alyssa Smith, LPN

  • Licensed Practical Nurse
  • Camp Hill, PA
National Provider Identifier
1811512346
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN295370 Issued in PA
Practice address
423 N 21St St
Camp Hill, PA 17011-2207
Phone
(717) 761-0930
Fax
(717) 761-0465
NPI assigned
Jun 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN295370 PA Primary

Addresses

Primary practice location

423 N 21St St
Camp Hill, PA 17011-2207

Mailing address

200 Grandview Ave Ste 101
Camp Hill, PA 17011-1777
Phone (717) 761-0930

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
PN295370PAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Siegelbaum Gastroenterology LTD PastSince Jun 14, 2020 Accepting new patients
Capital Anesthesia LLC PastSince Jun 14, 2020 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGCHDD

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1811512346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GRANDVIEW AVE STE 101",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170111777",
            "telephone_number": "717-761-0930",
            "fax_number": "717-761-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 N 21ST ST",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112207",
            "telephone_number": "717-761-0930",
            "fax_number": "717-761-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ALYSSA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-10",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "PN295370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Hill, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.