Active NPI
Shannon Alexandria Smith, RD
- Registered Dietitian
- Miami, FL
National Provider Identifier
1821603267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND7999
- Practice address
- 20621 NE 1St CT
Miami, FL 33179-1702 - Phone
- (305) 807-8622
- NPI assigned
- Sep 12, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | ND7999 | FL | Primary |
Addresses
Primary practice location
20621 NE 1St CT
Miami, FL 33179-1702
Mailing address
20621 NE 1St CT
Miami, FL 33179-1702
Phone (305) 807-8622
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ND7999 | Other | FL | LICENSE NUMBER |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | MIAMI | Health Information Exchange (HIE) |
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
| License | State | Type | Specialty |
|---|---|---|---|
| ND7999 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
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": "1599868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599868800000",
"number": "1821603267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20621 NE 1ST CT",
"city": "MIAMI",
"state": "FL",
"postal_code": "331791702",
"telephone_number": "305-807-8622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20621 NE 1ST CT",
"city": "MIAMI",
"state": "FL",
"postal_code": "331791702",
"telephone_number": "305-807-8622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "SHANNON",
"middle_name": "ALEXANDRIA",
"name_prefix": "Ms.",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-12",
"last_updated": "2020-09-12",
"certification_date": "2020-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND7999",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "ND7999",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "MIAMI",
"affiliation": "N",
"endpointDescription": "none",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "20621 NE 1st Ct",
"city": "Miami",
"state": "FL",
"country_code": "US",
"postal_code": "331791702",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.