MS. TINA I SMITH (NPI# 1053757948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1053757948 |
Entity Type | Individual |
Full Name | MS. TINA I SMITH |
Credential | PSS |
Practice Address |
3211 Autumn Chase Way Ne Apt 104 Salem OR 97305-1561 |
Practice Telephone | 9712399675 |
Mailing Telephone | 9712399675 |
Enumeration Date | 2013-05-17 |
Last Update Date | 2015-12-22 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 174400000X | Specialist | Other Service Providers | ||
N | 172V00000X | Community Health Worker | OR | Other Service Providers | |
Y | 175T00000X | Peer Specialist | Other Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | O5329 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740741511 | Tina M Smith | Registered Nurse | 1562 6th St N, Birmingham, AL 35204-2220 | 2019-03-26 |
1275020091 | Tina Suzette Smith | Licensed Vocational Nurse | 1105 Town Lake Dr, Longview, TX 75601-4927 | 2018-04-17 |
1558756361 | Tina Marcel Smith | Licensed Practical Nurse | 1095 Fountain Ln, Apt A, Columbus, OH 43213-4159 | 2015-03-30 |
1891189197 | Tina Lavette Smith | Home Health | 340 N Sam Houston Pkwy E Ste 243, Houston, TX 77060-3394 | 2015-03-24 |
1952543738 | Tina Marie Smith | Physician Assistant | 53 State St, Struthers, OH 44471-1981 | 2009-03-25 |
1174761563 | Tina M Smith | Behavioral Analyst | 2601 Manorwood Dr, Melbourne, FL 32901-5828 | 2009-01-23 |
1538347323 | Tina Nicole Smith | Physical Therapy Assistant | 505 Briarwood Dr, L8, Enterprise, AL 36330-5029 | 2008-02-05 |
1720273782 | Tina M Smith | Pediatrics | 310 E 8th St Ste 130, Marietta, OH 45750-3379 | 2007-09-12 |
1124241831 | Tina Carita Smith | Registered Nurse | 184 Professional Dr Unit A, Baldwin, GA 30511-4012 | 2007-04-11 |
1922155605 | Tina Lynne Smith | Speech-Language Pathologist | 10705 Greenbriar Chase, Oklahoma City, OK 73170-3214 | 2007-01-04 |
Street Address |
3211 AUTUMN CHASE WAY NE APT 104 |
City | SALEM |
State | OR |
Zip Code | 97305-1561 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821639147 | Christine Ann Featherstone | Social Worker | Chemawa Indian Health Center, 3750 Chemawa Road, Salem, OR 97305 | 2019-10-08 |
1962996553 | Erin Ann Wakefield | Non-emergency Medical Transport (VAN) | 2425 Fisher Rd Ne, Salem, OR 97305 | 2018-06-18 |
1770002271 | Traci L Lee | Case Manager/Care Coordinator | 3876 Beverly Ave Bldg G, Salem, OR 97305 | 2017-09-15 |
1952825762 | Matthew Paul Martin | Dentist | 2737 Lancaster Dr Ne Ste 150, Salem, OR 97305 | 2017-08-02 |
1043750367 | Sherri King | Physical Therapy Assistant | 4696 Reimann St Ne, Salem, OR 97305 | 2017-03-06 |
1760861314 | Amara Lenore Peterson | Counselor | 4347 Sunnyview Rd Ne, Salem, OR 97305 | 2015-05-28 |
1720467954 | Heather Rose | Community Health Worker | 4347 Sunnyview Road Ne, Salem, OR 97305 | 2015-05-20 |
1588057004 | Carmen Heidecke | Counselor | 4347 Sunnyview Rd. Ne, Salem, OR 97305 | 2015-03-08 |
1629476825 | Bryan James Greenaway | Audiologist | 3857 Wolverine St Ne Ste C-16, Salem, OR 97305 | 2014-12-21 |
1710300322 | Christopher Ryan | Counselor | 4385 Sunnyview Road Ne, Salem, OR 97305 | 2014-02-03 |
Find all providers in zip 97305 |
Taxonomy Code | 175T00000X |
Grouping | Other Service Providers |
Classification | Peer Specialist |
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528677820 | Charice Monette | Peer Specialist | 4151 Kacey Cir Ne, Salem, OR 97305-4504 | 2020-07-23 |
1821649336 | Christopher Adam Handy | Peer Specialist | 3050 Park Ave Ne, Salem, OR 97301-8615 | 2019-09-25 |
1922505767 | Amy Nicole Cozad | Peer Specialist | 4275 Commercial St Se Ste 180, Salem, OR 97302-4087 | 2018-04-09 |
1649785817 | Keileigh Joy Dull | Peer Specialist | 3213 Center St Ne, Salem, OR 97301-4666 | 2017-12-08 |
1104331370 | Christina E Higgins Korkow | Peer Specialist | 2555 Silverton Rd Ne, Salem, OR 97301-0837 | 2017-12-08 |
1437682044 | Debra Janae Rice | Peer Specialist | 2555 Silverton Rd Ne Ste C, Salem, OR 97301-0837 | 2017-04-10 |
1952834194 | Brian Smith | Peer Specialist | 769 Hawthorne Ave Ne, Salem, OR 97301-4623 | 2017-04-05 |
1588013577 | Sarah Harris | Peer Specialist | 4255 32nd Pl Ne, Salem, OR 97301-6735 | 2016-06-09 |
1194187476 | Tammi Paul | Peer Specialist | 1300 Broadway St Ne Ste 403, Salem, OR 97301-1420 | 2016-03-24 |
1710343926 | Teresa Anne Sims | Peer Specialist | 1599 State Street Ne, Salem, OR 97301 | 2016-01-05 |
Find all providers in SALEM |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.