1588612469 NPI number — DR. JANET E SMITH MD

Table of content: DR. JANET E SMITH MD (NPI 1588612469)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588612469 NPI number — DR. JANET E SMITH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SMITH
Provider First Name:
JANET
Provider Middle Name:
E
Provider Name Prefix Text:
DR.
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:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588612469
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1700 S MINNESOTA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SIOUX FALLS
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57105-1723
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-331-4493
Provider Business Mailing Address Fax Number:
605-331-0038

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1700 S MINNESOTA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SIOUX FALLS
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57105-1723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-331-4493
Provider Business Practice Location Address Fax Number:
605-331-0038
Provider Enumeration Date:
05/04/2006

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: 208800000X , with the licence number:  3576 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208800000X , with the licence number: 23067 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208800000X , with the licence number: 13528 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208800000X , with the licence number: C54864 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 10025195700 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 22849 . This is a "SIOUX VALLEY HEALTH PLAN" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 4334139 . This is a "AETNA" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 709085400 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7K939NO . This is a "CENTRAL STATES" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 7K940SM . This is a "MN BLUE CROSS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 7301282 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 897391019341 . This is a "PREFERRED ONE" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 460438016 . This is a "CHAMPUS" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 460438016000E . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 122089 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 0040053 . This is a "BLUE CROSS" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 0989319 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 460438016 . This is a "DAKOTACARE" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".




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