SHELLY COOPER SMITH (NPI# 1891053872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891053872 |
| Entity Type | Individual |
| Full Name | SHELLY COOPER SMITH |
| Credential | PA-C |
| Practice Address |
1915 West Park Drive Suite 101 North Wilkesboro NC 28659 |
| Mailing Address |
Po Box 602658 Charlotte NC 28260-2658 |
| Practice Telephone | 3366518700 |
| Mailing Telephone | 3367162011 |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2017-08-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
0010-03378 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437504222 | Shelly Smith | Licensed Practical Nurse | 912 Petoskey St, Petoskey, MI 49770-2937 | 2016-04-28 |
| 1609245752 | Shelly Smith | Respite Care | 6060 N Wildhorse Dr, Prescott Valley, AZ 86314-3346 | 2015-09-18 |
| 1518365667 | Shelly Smith | Registered Nurse | 458 Linwood St, Brooklyn, NY 11208-2132 | 2014-12-05 |
| 1457630774 | Shelly R Smith | Nurse Practitioner | 9000 Rockville Pike Nih Bldg 10 Rm 3n 210, Bethesda, MD 20892-0001 | 2011-08-04 |
| 1508075854 | Shelly E Smith | Pharmacist | 10501 New Haven Rd, Harrison, OH 45030-2734 | 2007-05-22 |
| 1386719771 | Shelly Jean Smith | Social Worker | 190 Delaware St., Sandusky, MI 48471 | 2006-11-21 |
| 1417911843 | Shelly P Smith | Nurse Practitioner | 3452 Anderson Hwy, Suite D, Powhatan, VA 23139-5845 | 2006-04-13 |
| 1992275721 | Shelly Smith | Technician | 401 N Oklahoma Ave, Mangum, OK 73554-3011 | 2018-12-05 |
| 1831626837 | Shelly Jean Marion Smith | Nurse Practitioner | 6973 Linda Vista Rd, San Diego, CA 92111-6342 | 2017-05-22 |
| 1295108504 | Shelly M Smith | Marriage & Family Therapist | 15300 Watertown Plank Rd Ste 106, Elm Grove, WI 53122-2348 | 2015-11-09 |
| Street Address |
1915 WEST PARK DRIVE SUITE 101 |
| City | NORTH WILKESBORO |
| State | NC |
| Zip Code | 28659 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831105832 | Jerald Mitchell Wiles Jr. | Physical Therapist | 1915 West Park Drive, Physical Therapy Associates of Wilkes LLC Ste 102, North Wilkesboro, NC 28659 | 2006-07-31 |
| 1215294848 | Robert Richard Keen | Dentist | 1915 West Park Drive, Suite #104, North Wilkesboro, NC 28659-3777 | 2012-04-20 |
| 1225192834 | County of Wilkes | Clinic/Center | 1915 West Park Drive, North Wilkesboro, NC 28659 | 2006-12-20 |
| 1922183920 | Physical Therapy Associates of Wilkes LLC | Physical Therapist | 1915 West Park Drive, Physical Thearpy Associates of Wilkes LLC Suite 102, North Wilkesboro, NC 28659 | 2006-10-26 |
| 1568555092 | Jerry Pinkerton,md Pa | Specialist | 1915 West Park Drive, Suite 103, North Wilkesboro, NC 28659 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013579689 | Lisa C Carr | Social Worker | 1400 Willow Ln # C61-2, North Wilkesboro, NC 28659 | 2019-07-03 |
| 1780141507 | Brenda Barber | Counselor | 200 Northview Plaza, North Wilkesboro, NC 28659 | 2019-02-28 |
| 1639696941 | Lifespan Incorporated | Community/Behavioral Health | 2070 River Road, North Wilkesboro, NC 28659 | 2017-08-28 |
| 1184146011 | Daymark Recovery Services Inc | Community/Behavioral Health | 200 C.c. Wright School Road, Classrooms 126, 127, North Wilkesboro, NC 28659 | 2017-07-12 |
| 1033568258 | Rgm Al Holdings, LLC | Assisted Living Facility | 240 Independence Ave, North Wilkesboro, NC 28659 | 2016-06-08 |
| 1376997999 | Hayden Church | Driver | 29 Boone Trail, North Wilkesboro, NC 28659 | 2016-04-20 |
| 1033563192 | Nathan Grant Davis | Emergency Medicine | Wake Forest Baptist Health- Wilkes Medical Center, 1370 W D St, North Wilkesboro, NC 28659 | 2016-04-14 |
| 1720425408 | Lindsay Brooke Spears | Dentist | 1915 West Park Drive Ste 104, Wilkes Public Health Dental West, North Wilkesboro, NC 28659 | 2013-06-04 |
| 1881983419 | Pruitthealth Hospice, Inc. | Hospice Care, Community Based | 902 West D St, Ste B, North Wilkesboro, NC 28659 | 2011-04-05 |
| 1275838096 | Barium Springs Home for Children | Community Based Residential Treatment Facility, Mental Illness | 517 Boston Ave, North Wilkesboro, NC 28659 | 2011-01-26 |
| Find all providers in zip 28659 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205365335 | Joe Gates | Physician Assistant | 408 8th St Ste 1, North Wilkesboro, NC 28659-4167 | 2017-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174170575 | Katherine Mccullough | Physician Assistant | Duke University Medicine Center 2301 Erwin Rd, Durham, NC 27710-0001 | 2019-08-20 |
| 1740845148 | Brenda Kay Dushek | Physician Assistant | 20 Medical Campus Dr Nw Ste 104, Supply, NC 28462-4094 | 2019-05-01 |
| 1851955579 | Morgan Elizabeth Bridgers | Physician Assistant | 4051 Burnett Womack Dept of Surgery Cb 7050, Chapel Hill, NC 27599-1843 | 2019-04-29 |
| 1265947725 | Molly Cunningham Pradhan | Physician Assistant | 2301 Erwin Road Dumc 2945, Durham, NC 27710-0001 | 2017-12-06 |
| 1497273700 | Joseph Cameron Jones | Physician Assistant | 404 Westwood Ave Ste 303, High Point, NC 27262-4315 | 2017-09-07 |
| 1871011106 | Tashianna Renee Stockton | Physician Assistant | 101 Manning Drive Cb #7600, Chapel Hill, NC 27599-0001 | 2017-09-07 |
| 1023547585 | Audrey Catherine Fortezzo | Physician Assistant | 581 Leroy George Dr Ste 300, Clyde, NC 28721-8085 | 2017-06-08 |
| 1184013294 | Danielle King | Physician Assistant | 3611 N Duke Street, Durham, NC 27704 | 2015-01-13 |
| 1629474978 | Gary Lee Aldrich Jr. | Physician Assistant | 103a Mcalpine Ln, Laurinburg, NC 28352-4637 | 2014-11-14 |
| 1255757936 | Megan Lenore Mcnamara | Physician Assistant | 2504 Delaney Ave, Wilmington, NC 28403-6002 | 2014-03-05 |
| Find all providers with the same taxonomy | ||||
| City | NORTH WILKESBORO |
| Zip Code | 28659 |
Please comment or provide details below to improve the information on SHELLY COOPER SMITH.
| 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.