Individual provider Active NPI

Katie Smith

  • Registered Nurse
  • Olean, NY
National Provider Identifier
1962268128
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
794704-01 Issued in NY
Practice address
1355 Olean Portville Rd
Olean, NY 14760-9416
Phone
(716) 373-0021
NPI assigned
Feb 26, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 794704-01 NY Primary

Addresses

Primary practice location

1355 Olean Portville Rd
Olean, NY 14760-9416

Mailing address

23 Oak St
Allegany, NY 14706-1116

Other identifiers 2

IdentifierTypeStateIssuer
161039939OtherNYALL OTHER INSURANCES
161039939MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ksmith3@casa-trinity.org

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
794704-01NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Casa-Trinity, Inc. PastSince Mar 3, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1962268128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 OAK ST",
            "city": "ALLEGANY",
            "state": "NY",
            "postal_code": "147061116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 OLEAN PORTVILLE RD",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147609416",
            "telephone_number": "716-373-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "794704-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALL OTHER INSURANCES",
            "identifier": "161039939",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161039939",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksmith3@casa-trinity.org",
            "affiliation": "N",
            "endpointDescription": "Personal Email Address",
            "address_1": "1355 Olean Portville Rd",
            "city": "Olean",
            "state": "NY",
            "country_code": "US",
            "postal_code": "147609416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olean, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.