Shanta Montraile Smith, CNA

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

PCH008442 Issued in GA

Practice address

121 W College St
Griffin, GA 30224-4220

Phone

(678) 702-4639

Fax

(678) 692-8131

NPI assigned

Aug 1, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1627776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627776000000",
    "number": "1982377271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 W COLLEGE ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244220",
            "telephone_number": "678-702-4639",
            "fax_number": "678-692-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W COLLEGE ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244220",
            "telephone_number": "678-702-4639",
            "fax_number": "678-692-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHANTA",
        "middle_name": "MONTRAILE",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-01",
        "last_updated": "2021-08-01",
        "certification_date": "2021-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "GA",
            "license": "PCH008442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "landingspch@gmail.com",
            "affiliation": "N",
            "endpointDescription": "building",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "121 W College St",
            "city": "Griffin",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302244220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matthew Smith
• Melanie P Smith, PA-C
• Phillip Chase Smith, PHARMD
• Robert W Smith
• Shanice Smith
• Tawni Marley Smith, CST
• William Valdon Smith
• Solutions to Thrive, LLC
• South Atlanta Lung and Sleep Clinic Inc.
• South Atlanta Radiology Associates- Griffin

• Custodial Care Facility in Griffin, GA
• Providers in Griffin, GA by specialty
• Custodial Care Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2021; 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.