Individual provider Active NPI

Brenda Smith

  • Registered Nurse
  • Snellville, GA
National Provider Identifier
1962940692
Registry record updated Feb 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN071509 Issued in GA
Practice address
4841 Lenora Church Rd
Snellville, GA 30039-7707
Phone
(404) 510-3888
Fax
(770) 679-9494
NPI assigned
Feb 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2017

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN071509 GA Primary
Administrator Registered Nurse 163WA2000X NHA005147 GA
Community Health Registered Nurse 163WC1500X RN071509 GA
Gerontology Registered Nurse 163WG0600X RN071509 GA
Home Health Registered Nurse 163WH0200X RN071509 GA
Medical-Surgical Registered Nurse 163WM0705X RN071509 GA

Addresses

Primary practice location

4841 Lenora Church Rd
Snellville, GA 30039-7707

Mailing address

4841 Lenora Church Rd
Snellville, GA 30039-7707
Phone (404) 510-3888

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
NHA005147GAMDAdministrator Registered Nurse
RN071509GAMDGerontology Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Smith & Associates Consulting Past Accepting new patients
Sunshine Dreamassisted Living LLC Past Accepting new patients

Organizations & group practices 2

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": "1485907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1962940692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4841 LENORA CHURCH RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300397707",
            "telephone_number": "404-510-3888",
            "fax_number": "770-679-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4841 LENORA CHURCH RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300397707",
            "telephone_number": "404-510-3888",
            "fax_number": "770-679-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRENDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-01",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN071509",
            "primary": true
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "GA",
            "license": "NHA005147",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "GA",
            "license": "RN071509",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "GA",
            "license": "RN071509",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "GA",
            "license": "RN071509",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "GA",
            "license": "RN071509",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.