Individual provider Active NPI

Yolonda Coleman Smith, AGACNP

  • Acute Care Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1992384945
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
904204 Issued in MS
Practice address
6508 Dogwood View Pkwy
Suite C
Jackson, MS 39213-7868
Phone
(301) 532-7685
NPI assigned
Apr 6, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2100X 904204 MS Primary

Addresses

Primary practice location

6508 Dogwood View Pkwy
Suite C
Jackson, MS 39213-7868

Mailing address

103 Stonebrook CT
Clinton, MS 39056-9684
Phone (601) 910-1264

Other practice location 1

6508 Dogwood View Pkwy
Jackson, MS 39213-7875
Phone (301) 532-7685

Other names 1

  • Yolonda Coleman Professional name

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
904204MSMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1992384945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 STONEBROOK CT",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390569684",
            "telephone_number": "601-910-1264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6508 DOGWOOD VIEW PKWY",
            "address_2": "SUITE C",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392137868",
            "telephone_number": "301-532-7685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6508 Dogwood View Pkwy",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392137875",
            "country_code": "US",
            "telephone_number": "301-532-7685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "YOLONDA",
        "middle_name": "COLEMAN",
        "name_prefix": "Mrs.",
        "credential": "AGACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "904204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YOLONDA",
            "last_name": "COLEMAN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.