1154333532 NPI number — SAMANTHA TIMMONS READ-SMITH MD

Table of content: SAMANTHA TIMMONS READ-SMITH MD (NPI 1154333532)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154333532 NPI number — SAMANTHA TIMMONS READ-SMITH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
READ-SMITH
Provider First Name:
SAMANTHA
Provider Middle Name:
TIMMONS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TIMMONS
Provider Other First Name:
SAMANTHA
Provider Other Middle Name:
CURTIS
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1154333532
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/02/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
509 BILTMORE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28801-4601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-213-0273
Provider Business Mailing Address Fax Number:
866-285-9740

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
509 BILTMORE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28801-4601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-213-0273
Provider Business Practice Location Address Fax Number:
866-285-9740
Provider Enumeration Date:
08/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208M00000X , with the licence number:  016368 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 016368 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: 2011-00625 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 2011-00625 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 30204929 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 413430099 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".




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