Percy Smith
Individual provider Active NPI Community Health Worker · Loudon, WV
NPI 1982283628 · NPPES record last updated Apr 7, 2021
Key facts
- NPI
- 1982283628
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 1 Smith Lane
Loudon, WV 25126 - Phone
- (410) 800-6497
- NPI assigned
- Apr 7, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Yes |
Addresses
Primary practice location
1 Smith Lane
Loudon, WV 25126
Mailing address
PO Box 7
London, WV 25126-0007
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.