Active NPI
Divia L. Smith, NP
- Family Nurse Practitioner
- Pineville, NC
National Provider Identifier
1942822788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 197065
- Practice address
- 11611 Stockdale CT
Pineville, NC 28134-6422 - Phone
- (803) 487-5918
- NPI assigned
- May 14, 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 197065 | GA | Primary |
Addresses
Primary practice location
11611 Stockdale CT
Pineville, NC 28134-6422
Mailing address
11611 Stockdale CT
Pineville, NC 28134-6422
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 197065 | GA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589414400000",
"number": "1942822788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11611 STOCKDALE CT",
"city": "PINEVILLE",
"state": "NC",
"postal_code": "281346422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11611 STOCKDALE CT",
"city": "PINEVILLE",
"state": "NC",
"postal_code": "281346422",
"telephone_number": "803-487-5918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "DIVIA",
"middle_name": "L.",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-14",
"last_updated": "2020-05-14",
"certification_date": "2020-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "197065",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pineville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.