DR. MAURICE BRADLEY SMITH (NPI# 1467547257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467547257 |
| Entity Type | Individual |
| Full Name | DR. MAURICE BRADLEY SMITH |
| Credential | PH.D.,L.P. |
| Practice Address |
1935 County Road B2 W Ste 270 Roseville MN 55113-2785 |
| Practice Telephone | 6514810664 |
| Practice Fax Number | 6518465877 |
| Mailing Telephone | 6514810664 |
| Mailing Fax Number | 6518465877 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2019-02-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
LP0783 | MN | Behavioral Health & Social Service Providers |
| N | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
LP0783 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLUE CROSS/BLUE SHIELD | 27F90SM | 01 |
| MN | RAIL ROAD MEDICARE | 680016304 | 01 |
| MN | HEALTH PARTNERS INSURANCE | HP21325 | 01 |
| MN | MEDICA/UNITED BEH. HEALTH | 6150656 | 01 |
| MN | 092353200 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972012169 | Maurice Allan Smith | Peer Specialist | 16 W Long St., Columbus, OH 43215 | 2017-09-20 |
| 1871897736 | Maurice Camp Smith | Neurological Surgery | 32 Cemetery Rd, Park City, MT 59063-9429 | 2011-01-06 |
| 1639160690 | Maurice William Smith | Chiropractor | 357 Warner Milne Rd, Oregon City, OR 97045-4045 | 2005-10-31 |
| 1568080430 | Maurice Smith | Social Worker | 1601 Brenner Ave, Salisbury, NC 28144-2515 | 2020-07-08 |
| 1326207531 | Maurice Dorian Smith | Counselor | 4300 Sw 13th St, Gainesville, FL 32608-4006 | 2008-06-03 |
| 1740302686 | Maurice Antonio Smith | Surgery | 501 W 7th St, Suite D, Frederick, MD 21701-4586 | 2007-04-04 |
| 1033279534 | Maurice Edward Smith | Dentist | 3870 Peachtree Industrial Blvd, #220, Duluth, GA 30096-1422 | 2006-12-12 |
| 1912998600 | Maurice M Smith | Neurological Surgery | 6325 Humphreys Blvd, Semmes- Murphey Clinic, Memphis, TN 38120-2300 | 2005-11-02 |
| Street Address |
1935 COUNTY ROAD B2 W STE 270 |
| City | ROSEVILLE |
| State | MN |
| Zip Code | 55113-2785 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295738029 | Todd Michael Sigler | Counselor | 1935 County Road B2 W Ste 270, Roseville, MN 55113-2785 | 2005-05-24 |
| 1942863378 | Tutapona Inc | Clinic/Center | 1935 County Road B2 W Ste 270, Roseville, MN 55113-2785 | 2019-04-22 |
| 1831316025 | Carl Gaede | Social Worker | 1935 County Road B2 W Ste 270, Roseville, MN 55113-2785 | 2007-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396384376 | Zachary Mattson | Physician Assistant | Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 | 2019-12-23 |
| 1467010330 | Ahmed Issa | Student in an Organized Health Care Education/Training Program | 1550 Larpenteur Ave W, Apt 235, St Paul, MN 55113 | 2019-06-05 |
| 1821653833 | Suite Living Senior Care of Little Canada | Assisted Living Facility | 2740 Rice Street, Little Canada, MN 55113 | 2019-05-06 |
| 1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
| 1588138473 | Applewood Home Health Care, LLC | Home Health | 2021 E Hennepin Avenue # 402-1, Minneapolis, MN 55113 | 2019-01-14 |
| 1699251520 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2685 Patton Rd, Roseville, MN 55113 | 2018-07-13 |
| 1083104145 | Suite Living Senior Care of Roseville | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55113 | 2018-05-15 |
| 1477055796 | Sunrise Residential Services LLC | Home Health | 216 Maple Ln, Roseville, MN 55113 | 2018-03-02 |
| 1194223024 | Alissa Hoff | Specialist | 1595 Mn 36 - 584 10 Rosedale Center, Roseville, MN 55113 | 2018-01-25 |
| 1841705118 | Kingsland Care Services Incorporated | Case Management | 2301 Rice Street, Suite 101, Roseville, MN 55113 | 2017-12-08 |
| Find all providers in zip 55113 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205287885 | Layla Asamarai | Psychologist | 1611 County Road B W Ste 218, Roseville, MN 55113-4053 | 2016-06-25 |
| 1578939658 | Patricia L. Bach, Psyd, Inc., A Psychological Corporation | Psychologist | 300 Harding Blvd Ste 203k, Roseville, CA 95678-2474 | 2015-08-12 |
| 1760815229 | Tamarind P Knutson, LLC | Psychologist | 2579 Hamline Ave N Ste D, Roseville, MN 55113-3187 | 2013-08-19 |
| 1699021766 | Jazmine Mccoy | Psychologist | 8775 Sierra College Blvd Ste 250, Roseville, CA 95661-5986 | 2012-07-26 |
| 1437393287 | Kelly & Nguyen-kelly Psychological and Consulting Services, LLC | Psychologist | 1315 Larpenteur Ave W, Suite I, Roseville, MN 55113-6323 | 2009-04-23 |
| 1508087909 | Nicole Solomon | Psychologist | 1660 E Roseville Pkwy Ste 160, Roseville, CA 95661-3988 | 2007-05-01 |
| 1427273507 | Randy Allan Gilchrist I | Psychologist | 1899 E Roseville Pkwy Ste 100, Roseville, CA 95661-7980 | 2007-04-16 |
| 1033246137 | Heather Jane Forde | Psychologist | 970 Reserve Dr Ste 205, Roseville, CA 95678-1378 | 2007-02-27 |
| 1023159191 | Michael A. Molyn | Psychologist | Valley Psychological Center, 1891 E. Roseville Parkway, Suite 100, Roseville, CA 95661 | 2007-02-09 |
| 1427197540 | Travis H Owens | Psychologist | 1891 East Roseville Parkway, Suite 100, Roseville, CT 95661-7979 | 2007-02-05 |
| Find all providers in ROSEVILLE | ||||
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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.