Anna Cornelia Smith, MSN, LMT, CN,

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT21706344 Issued in IN

Practice address

51803 Tall Pines Dr
Elkhart, IN 46514

Phone

(574) 361-2847

NPI assigned

Apr 17, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing

State licenses

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526169600000",
    "number": "1922595792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51803 TALL PINES DR",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465145971",
            "telephone_number": "574-361-2847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51803 TALL PINES DR",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "46514",
            "telephone_number": "574-361-2847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANNA",
        "middle_name": "CORNELIA",
        "name_prefix": "Mrs.",
        "credential": "MSN, LMT, CN,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-17",
        "last_updated": "2018-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "WA",
            "license": "NU00001939",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501010943",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IN",
            "license": "MT21706344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emma R Smith, MSW
• Jerold Robert Smith, RPH
• Judith Lynn Smith, PA-C

• Massage Therapist in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Massage Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2018; 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.