BRANDY JO SMITH (NPI# 1558878702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558878702 |
| Entity Type | Individual |
| Full Name | BRANDY JO SMITH |
| Credential | PA-C |
| Practice Address |
3500 W Purdue Ave Muncie IN 47304-6357 |
| Practice Telephone | 7657476090 |
| Practice Fax Number | 7657475069 |
| Mailing Telephone | 7657476090 |
| Mailing Fax Number | 7657475069 |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2020-10-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | PHYSICIAN ASSISTANT LICENSE | 10002401A | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 13121 Olio Rd, Fishers, IN 460377237 | 7657476090 | 7657475069 |
| 1331 S A St, Elwood, IN 460361942 | 7657476090 | 7657475069 |
| 1710 S Spiceland Rd, New Castle, IN 473629101 | 7657476090 | 7657475069 |
| 1941 Virginia Ave, Connersville, IN 473312833 | 7657476090 | 7657475069 |
| 830 Sim Hodgin Pkwy, Richmond, IN 473741931 | 7657476090 | 7657475069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235627654 | Brandy S Smith | Behavioral Analyst | 136 Premier Ln, Carbondale, IL 62902-4101 | 2018-05-01 |
| 1851891584 | Brandy R Smith | Licensed Vocational Nurse | 210 W Walnut St Apt 30, Huntington, TX 75949-8501 | 2018-02-19 |
| 1992203079 | Brandy J Smith | Nurse Practitioner | 703 Green Rd Ste 1, Madison, IN 47250-2145 | 2018-01-24 |
| 1447761390 | Brandy Michelle Smith | Clinic/Center | 99 Quail Brook Dr, Texarkana, TX 75501-2062 | 2017-10-18 |
| 1881007763 | Brandy Michelle Smith | Counselor | 1711 Highgate Dr, Duncanville, TX 75137-4110 | 2014-06-09 |
| 1487940821 | Brandy J Smith | Counselor | 2801 N Decatur Rd Ste 185, Decatur, GA 30033-5924 | 2011-06-23 |
| 1154582104 | Brandy Renee' Smith | Social Worker | 5730 S May Ave, Oklahoma City, OK 73119-5604 | 2008-06-23 |
| 1871767608 | Brandy Lynn Smith | Licensed Practical Nurse | 768 Orangeburg Ct, Columbus, OH 43228-5736 | 2008-04-14 |
| 1184249740 | Brandy Smith | Registered Nurse | 9846 Hwy 31 E, Tyler, TX 75705-2329 | 2020-06-10 |
| 1588298848 | Brandy D Smith | Licensed Practical Nurse | 955 Windham Ct Ste 2, Boardman, OH 44512-5035 | 2020-02-26 |
| Street Address |
3500 W PURDUE AVE |
| City | MUNCIE |
| State | IN |
| Zip Code | 47304-6357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811901184 | Alexander Zemtsov | Dermatology | 3500 W Purdue Ave, Muncie, IN 47304-6357 | 2006-07-29 |
| 1437787066 | Stephanie L Sullender | Physician Assistant | 3500 W Purdue Ave, Muncie, IN 47304-6357 | 2020-03-30 |
| 1235228917 | Preswinda Cornejo Freeman | Nurse Practitioner | 3500 W Purdue Ave, Muncie, IN 47304-6357 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821627191 | Free To Flourish Counseling and Consulting | Marriage & Family Therapist | 4304 W Coyote Run Court, Muncie, IN 47304 | 2020-04-07 |
| 1205477957 | Muncie Treatment Center, LLC | Clinic/Center | 3640 Briarwood Lane, Muncie, IN 47304 | 2019-10-03 |
| 1508415225 | Susanna Florence Nalliah I | Pharmacist | Iu Health Ball Memorial Hospital Inpatient Pharmacy, 2401 W. University Ave, Muncie, IN 47304 | 2019-09-05 |
| 1235624289 | Kregg Koons O.d., Inc. | Optometrist | 3300 Purdue Ave., Muncie, IN 47304 | 2018-06-22 |
| 1013409242 | Julia Powers | Social Worker | 8425 W Ashford Ln, Muncie, IN 47304 | 2018-06-04 |
| 1851803456 | Dianna Marie Johnson | Nurse Practitioner | 3411 N Briarwood Ln, Muncie, IN 47304 | 2017-11-04 |
| 1780082917 | Quad Med LLC | Clinic/Center | 3800 West Kilgore Ave, Muncie, IN 47304 | 2014-12-22 |
| 1629418173 | Mark Allen Wise | Physical Therapist | 3607 N Everbrook Lane, Muncie, IN 47304 | 2013-06-28 |
| 1396094280 | Planned Parenthood of Indiana Muncie | Clinic/Center | 3550 W. Fox Ridge Lane, Muncie, IN 47304 | 2012-09-06 |
| 1043595655 | Olukayode Bamidele | Physical Therapist | 3601 W. Moore Road, Muncie, IN 47304 | 2011-10-14 |
| Find all providers in zip 47304 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851801880 | Kathryn E Kruse | Physician Assistant | 2401 W University Ave, Muncie, IN 47303-3428 | 2017-10-04 |
| 1942719596 | Abigail L Davis | Physician Assistant | 2401 W University Ave, Muncie, IN 47303-3428 | 2017-09-27 |
| 1942662739 | Laura Marquez | Physician Assistant | 4008 W Bethel Ave, Muncie, IN 47304-5442 | 2016-03-22 |
| 1225374465 | Nicole Brown | Physician Assistant | 2401 W University Ave, Muncie, IN 47303-3428 | 2012-12-17 |
| 1316246226 | James Robert Bush | Physician Assistant | 2401 W University Ave, Muncie, IN 47303-3428 | 2011-03-17 |
| 1992001127 | Jessica Marie Templeton | Physician Assistant | 2401 W University Ave, Muncie, IN 47303-3428 | 2011-02-05 |
| 1568611077 | Jeremiah W Stewart | Physician Assistant | 2401 W University Ave, Muncie, IN 47303-3428 | 2008-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063019289 | Timothy Jeffirs | Physician Assistant | 10662 12th Rd, Argos, IN 46501-9551 | 2020-10-01 |
| 1093321788 | April Marie Przyborski | Physician Assistant | 1701 S Creasy Ln Ste 2j20, Lafayette, IN 47905-4972 | 2020-09-18 |
| 1124634936 | Brilyn Michelle Banister | Physician Assistant | 8443 Cabin Creek Dr Apt G, Indianapolis, IN 46237-6330 | 2020-09-17 |
| 1386290625 | Douglas R Day | Physician Assistant | 1701 N Senate Blvd # Ag373a, Indianapolis, IN 46202-1239 | 2019-08-13 |
| 1841851409 | Rachel Jagrowski | Physician Assistant | 1801 N Senate Blvd Ste 700, Indianapolis, IN 46202-1177 | 2019-06-25 |
| 1366003154 | Jimmy Garala | Physician Assistant | 101 E 87th Ave Fl A3, Merrillville, IN 46410-7335 | 2019-06-24 |
| 1407311814 | William Peter Thompson | Physician Assistant | 1801 N Capitol Ave # Npe120, Indianapolis, IN 46202-1217 | 2019-02-11 |
| 1669954475 | Erika Vanelle Marin | Physician Assistant | 2680 Escalade Way, Warsaw, IN 46582 | 2018-08-29 |
| 1225518228 | Jie Xu | Physician Assistant | 2072 E Commercial Ave, Lowell, IN 46356-2116 | 2018-08-19 |
| 1912492679 | Katherine Barrett Tenbarge | Physician Assistant | 1800 N Capitol Ave # E140, Indianapolis, IN 46202-1218 | 2018-06-26 |
| 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.