Individual provider Active NPI

Janay Jasmine Smalls

  • Child & Adolescent Psychiatric/Mental Health Registered Nurse
  • Syracuse, NY
National Provider Identifier
1811518210
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X
License
669390 Issued in NY
Practice address
430 Irving Ave
Syracuse, NY 13210-2343
Phone
(315) 426-7640
NPI assigned
Apr 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 669390 NY Primary

Addresses

Primary practice location

430 Irving Ave
Syracuse, NY 13210-2343

Mailing address

236 Wayland Rd
Syracuse, NY 13208-3316
Phone (315) 560-1228

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
669390NYMDChild & Adolescent Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1811518210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 WAYLAND RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132083316",
            "telephone_number": "315-560-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102343",
            "telephone_number": "315-426-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLS",
        "first_name": "JANAY",
        "middle_name": "JASMINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "NY",
            "license": "669390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.