Individual provider Active NPI

Sophia Collins Smith, LPN

  • Licensed Practical Nurse
  • Southfield, MI
National Provider Identifier
1831625029
Registry record updated May 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703111821 Issued in MI
Practice address
23300 Providence Dr
Apt 818
Southfield, MI 48075-3652
Phone
(248) 242-0522
NPI assigned
May 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2017

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 4703111821 MI Primary

Addresses

Primary practice location

23300 Providence Dr
Apt 818
Southfield, MI 48075-3652

Mailing address

23300 Providence Dr
Apt 818
Southfield, MI 48075-3652
Phone (248) 242-0522

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
4703111821MIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1494115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494115200000",
    "number": "1831625029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23300 PROVIDENCE DR",
            "address_2": "APT 818",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753652",
            "telephone_number": "248-242-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23300 PROVIDENCE DR",
            "address_2": "APT 818",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753652",
            "telephone_number": "248-242-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS SMITH",
        "first_name": "SOPHIA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-07",
        "last_updated": "2017-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703111821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2017; 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.