Addie Sunmbo Smith, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041.380730 Issued in IL

Practice address

15475 S Park Ave Ste 110
South Holland, IL 60473-1378

Phone

(708) 321-8218

Fax

(708) 321-8219

NPI assigned

Jul 13, 2017

Sex

Female

Sole proprietor

No

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)

Not enrolled

Credentials

Registered Nurse

State licenses

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.

• Divine Home Care Services

  • In Home Supportive Care Agency
  • Stockton, CA
  • NPI 1720817067
  NPD
• Divine Home Care Services

  • Home Health Agency
  • Stockton, CA
  • NPI 1891533477
  NPD

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499904000000",
    "number": "1922520683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15475 S PARK AVE STE 110",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15475 S PARK AVE STE 110",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731378",
            "telephone_number": "708-321-8218",
            "fax_number": "708-321-8219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ADDIE",
        "middle_name": "SUNMBO",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-13",
        "last_updated": "2017-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.380730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shiloh Hospice & Palliative Care, LLC
• Tayler Victoria Simon
• Smiles of Tomorrow, LTD
• Smiles of Tomorrow,PC
• Patricia Smith-Huntoon
• Erica S Smith
• Lolita Smith, M.D.
• Nyree Smith, RN
• Robert E Smith
• Sheree L Sneed

• Registered Nurse in South Holland, IL
• Providers in South Holland, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.