Elizabeth Mary Timm Smith, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

6738-33 Issued in WI

Practice address

8600 Sheridan Rd
Suite 600
Kenosha, WI 53143-6506

Phone

(262) 605-6767

NPI assigned

Dec 8, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Kenosha County Div of Public Health

  • Clinical Medical Laboratory
  • Kenosha, WI
  • NPI 1477744472
  NPD (past)
• Kenosha County Division of Health

  • Public Health or Welfare Agency
  • Kenosha, WI
  • NPI 1467643130
  NPD (past)

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

{
    "created_epoch": "1449532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1922473578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 SHERIDAN RD",
            "address_2": "SUITE 600",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531436506",
            "telephone_number": "262-605-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 SHERIDAN RD",
            "address_2": "SUITE 600",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531436506",
            "telephone_number": "262-605-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ELIZABETH",
        "middle_name": "MARY TIMM",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-08",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "6738-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Smerko, CPO, LPO
• Smile Doctors LTD
• Lisa Smith-Nowak, RN
• Abigail L Smith, LAT
• David Smith, LPC
• Karen D Smith, APNP-BC
• Madeline Marie Smith
• Rachel M Smith, FNP
• Rochelle Smith
• Shawnna Smith

• Family Nurse Practitioner in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.