DERRELL SMITH (NPI# 1700276243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700276243 |
| Entity Type | Individual |
| Full Name | DERRELL SMITH |
| Practice Address |
130 E Bissell St Syracuse NY 13207-1801 |
| Mailing Address |
130 East Bissell Street Syracuse NY 13205 |
| Practice Telephone | 3159563690 |
| Mailing Telephone | 3159563690 |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2015-02-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 321023 | NY | Nursing Service Providers |
| Street Address |
130 E BISSELL ST |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13207-1801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588150254 | Tonia Michelle Moore | Licensed Practical Nurse | 621 West Brighton Ave, Syracuse, NY 13207 | 2018-07-06 |
| 1992154710 | Alza Theresa Johnson | Licensed Vocational Nurse | 139 Clyde Ave, Syracuse, NY 13207 | 2016-06-13 |
| 1932528627 | Chakira Harris | Licensed Practical Nurse | 943 West Lafayette Ave, Apt 2, Syracuse, NY 13207 | 2014-04-10 |
| 1598195471 | Brittany St. Dennis | Licensed Practical Nurse | 134 Swrhill Terrace, Syracuse, NY 13207 | 2013-11-14 |
| 1417380445 | Terence White | Registered Nurse | 314 Palmer Ave, Syracuse, NY 13207 | 2013-08-13 |
| 1447587795 | Lauren C Belair | Licensed Practical Nurse | 3665 Gardenia Dr., Baldwinsville, NY 13207 | 2009-11-06 |
| 1497088843 | Eileen R. Mchale | Speech-Language Pathologist | 301 Valley Drive, Parkside Children's Center, Syracuse, NY 13207 | 2009-09-16 |
| 1114160199 | Melissa Ann Clark | Licensed Practical Nurse | 113 Cheney St, Syracuse, NY 13207 | 2009-04-07 |
| 1356565675 | Mary Agnes Wykstra | Registered Nurse | 1540 Glenwood Ave, Syracuse, NY 13207-1011 | 2007-04-11 |
| 1326297482 | Kelly Lorraine Evans | Registered Nurse | 1540 Glenwood Ave, Syracuse, NY 13207-1011 | 2008-09-14 |
| Find all providers in zip 13207 | ||||
| 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 |
|---|---|---|---|---|
| 1053927848 | Gwendolyn Jane Thomas | Licensed Practical Nurse | 139 Hayden Ave, Syracuse, NY 13204-1509 | 2020-09-17 |
| 1780200758 | Stacey R Green | Licensed Practical Nurse | 707 Meadowbrook Dr, Syracuse, NY 13210-3113 | 2020-06-24 |
| 1033743539 | Mindy Joy Cottrell | Licensed Practical Nurse | 515 Florida Rd, Syracuse, NY 13211-1220 | 2020-02-24 |
| 1205474772 | Mary Kresser | Licensed Practical Nurse | 214 Lafayette Rd, Syracuse, NY 13205-2921 | 2019-12-16 |
| 1528602166 | Rebecca Anne Snyder | Licensed Practical Nurse | 510 Greenwood Pl, Syracuse, NY 13210-2526 | 2019-11-06 |
| 1386286094 | Wendolyn Alicia White | Licensed Practical Nurse | 304 Martin Luther King W, Syracuse, NY 13205-1023 | 2019-10-14 |
| 1609423516 | Kortia Poole | Licensed Practical Nurse | 4574 Onondaga Blvd Apt 38, Syracuse, NY 13219-3308 | 2019-08-25 |
| 1649822826 | Tyrone Lamont Hunter | Licensed Practical Nurse | 620 Erie Blvd W Ste 620erie, Syracuse, NY 13204-2445 | 2019-07-09 |
| 1265099378 | Trina Leigh-marie Stearns | Licensed Practical Nurse | 525 Mosley Drive, Syracuse, NY 13206 | 2019-05-23 |
| 1699339242 | Gia Ruffini | Licensed Practical Nurse | 212 South Terry Rd., Syracuse, NY 13219 | 2019-04-30 |
| Find all providers in SYRACUSE | ||||
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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.