MR. JOHNATHON CRAWFORD SMITH SR. (NPI# 1275718660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275718660 |
| Entity Type | Individual |
| Full Name | MR. JOHNATHON CRAWFORD SMITH SR. |
| Credential | CLPN |
| Practice Address |
165 Bankhead Rd Sw Mantachie MS 38855-7267 |
| Mailing Address |
165 Bankhead Road Mantachie MS 38855-7265 |
| Practice Telephone | 6628401944 |
| Mailing Telephone | 6628401944 |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2008-01-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | P231371 | MS | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205193067 | Johnathon Quintrell Smith | Anesthesiology | 2105 E South Blvd, Montgomery, AL 36116-2409 | 2012-04-18 |
| Street Address |
165 BANKHEAD RD SW |
| City | MANTACHIE |
| State | MS |
| Zip Code | 38855-7267 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356997985 | Sonshine Pharmacy, LLC | Pharmacy | 2745 Highway 371 N, Mantachie, MS 38855 | 2019-08-09 |
| 1053885673 | Mantachie Rural Health Care, Inc | Clinic/Center | 311 Mustang Drive, Mantachie, MS 38855 | 2019-01-16 |
| 1992292536 | Mantachie Pharmacy LLC | Pharmacy | 3309 Highway 371 N, Mantachie, MS 38855 | 2018-04-19 |
| 1720589070 | Mantachie Rural Health Care Inc Behavioral Health | Clinic/Center | 5510 Hwy 363, Mantachie, MS 38855 | 2018-02-22 |
| 1962816447 | Travis Castleberry | Physical Therapist | 230a Main Street, Nettleton, MS 38855 | 2014-06-12 |
| 1891907093 | Community Family Healthcare, Inc | Nurse Practitioner | 285 Ivie Lane, Mantachie, MS 38855 | 2007-05-03 |
| 1750307328 | Freds Stores of Tennessee Inc | Durable Medical Equipment & Medical Supplies | 67 Watson Dr, Mantachie, MS 38855 | 2006-07-15 |
| 1497063085 | Jennifer Emily Bass | Specialist | 275 Morning View Lane, Mantachie, MS 38855-7096 | 2010-09-17 |
| 1780169557 | Andrea Carpenter | Nurse Practitioner | 3275 Highway 371 N, Mantachie, MS 38855-7145 | 2018-09-27 |
| 1164987426 | Hometown Care of Mantachie LLC | Nurse Practitioner | 3275 Highway 371 N, Mantachie, MS 38855-7145 | 2019-01-31 |
| Find all providers in zip 38855 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568757 | Iman A Reed | Licensed Practical Nurse | 8 Ashbury Pl, Columbia, MS 39429-3729 | 2020-11-04 |
| 1124631023 | Mychell Thomas | Licensed Practical Nurse | 199 Charmant Place, Ridgeland, MS 39157 | 2020-08-28 |
| 1083232250 | Remco Leidelmeijer | Licensed Practical Nurse | 54 Windance Dr, Carriere, MS 39426-7947 | 2020-07-14 |
| 1033733951 | Bonita T Roby | Licensed Practical Nurse | 1762 Eddisville Rd, Durant, MS 39063-2910 | 2020-06-05 |
| 1760011084 | Felicia Taylor | Licensed Practical Nurse | 1125 William Warren Rd, Collins, MS 39428-5692 | 2020-04-07 |
| 1003450321 | Donna Robinson | Licensed Practical Nurse | 70203 Royal Ct, Brandon, MS 39042-2930 | 2019-10-30 |
| 1093358202 | Alexesia S. Williams | Licensed Practical Nurse | 48 Charleston Way, Hattiesburg, MS 39402-8296 | 2019-10-21 |
| 1487212585 | Lesia Denise Gipson | Licensed Practical Nurse | 375a Love Cv, Brandon, MS 39042-8320 | 2019-06-03 |
| 1265995740 | Sandra Ferrill | Licensed Practical Nurse | 8321 Amoka Dr, Diamondhead, MS 39525-4060 | 2019-04-10 |
| 1821551946 | Mark Dewayne Bridgfes | Licensed Practical Nurse | 11 Sims Thornhill Rd, Tylertown, MS 39667-6104 | 2019-04-08 |
| Find all providers with the same taxonomy | ||||
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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.