Individual provider Active NPI

Deloris Smalley

  • Intellectual & Developmental Disabilities Psychologist
  • Midland, GA
National Provider Identifier
1821480906
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
License
103TM1800X Issued in GA
Practice address
9021 Veterans Pkwy
Midland, GA 31820-3411
Phone
(706) 660-9926
NPI assigned
Feb 25, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities Psychologist 103TM1800X 103TM1800X GA Primary

Addresses

Primary practice location

9021 Veterans Pkwy
Midland, GA 31820-3411

Mailing address

9021 Veterans Pkwy
Midland, GA 31820-3411
Phone (706) 596-5575

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
103TM1800XGAMDIntellectual & Developmental Disabilities Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1821480906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9021 VETERANS PKWY",
            "city": "MIDLAND",
            "state": "GA",
            "postal_code": "318203411",
            "telephone_number": "706-596-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9021 VETERANS PKWY",
            "city": "MIDLAND",
            "state": "GA",
            "postal_code": "318203411",
            "telephone_number": "706-660-9926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLEY",
        "first_name": "DELORIS",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-25",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "GA",
            "license": "103TM1800X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.