TYRONE SMITH (NPI# 1548729080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548729080 |
| Entity Type | Individual |
| Full Name | TYRONE SMITH |
| Practice Address |
135 Bradford Sq Ste B Fayetteville GA 30215-1902 |
| Mailing Address |
1419 Village Creek Cir Se Atlanta GA 30316-3281 |
| Practice Telephone | 4706735541 |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2019-03-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
226925 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | N/A | 058446472 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669516233 | Tyrone P. Smith Sr. | Chiropractor | 2609 Cantrell Rd, Harrisonville, MO 64701-4002 | 2007-02-16 |
| 1508213950 | Tyrone Smith | Case Manager/Care Coordinator | 2600 W 9th St, Chester, PA 19013-2040 | 2016-05-16 |
| 1548579592 | Tyrone Smith | Dentist | 10010 Dupont Circle Ct, Fort Wayne, IN 46825-1626 | 2010-09-24 |
| Street Address |
135 BRADFORD SQ STE B |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30215-1902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366847444 | Roselande Domond | Counselor | 135 Bradford Sq Ste B, Fayetteville, GA 30215-1902 | 2014-10-30 |
| 1497387963 | Diamond Counseling and Coaching, LLC | Counselor | 135 Bradford Sq Ste B, Fayetteville, GA 30215-1902 | 2020-02-12 |
| 1285119925 | Mindset Healthcare, PC | Nurse Practitioner | 135 Bradford Sq Ste B, Fayetteville, GA 30215-1902 | 2018-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801370051 | Truly Nourished, LLC | Dietitian, Registered | 500 West Lanier Ave., Suite 908, Fayetteville, GA 30215 | 2018-09-23 |
| 1104343839 | Pandora G Brown | Specialist | 65 Black Watch Ct, Fayetteville, GA 30215 | 2017-08-23 |
| 1902264492 | Ty-re Lamont Dixon Sr. | Durable Medical Equipment & Medical Supplies | 220 Shoreline Dr., Fayetteville, GA 30215 | 2016-01-29 |
| 1962870030 | Matthew Christian Alvarez | Dentist | 113 Ebenezer Rd Ste 101, Fayetteville, GA 30215 | 2015-09-08 |
| 1831534346 | Kevin Tyler Goelz | Radiology | 605 Wentworth Ct, Fayetteville, GA 30215 | 2013-05-10 |
| 1518249739 | William J. Holcomb | Pharmacist | 880 Hwy 85 South, Fayetteville, GA 30215 | 2011-09-14 |
| 1407168131 | All Care Home Health Equipment, LLC | Durable Medical Equipment & Medical Supplies | 1000 Cooper Circle, Suite 201, Fayetteville, GA 30215 | 2010-07-10 |
| 1083854160 | Rachel Blanks | Licensed Practical Nurse | 170 Brookwood Lane, Fayetteville, GA 30215 | 2009-03-02 |
| 1093964975 | Brenda Carole Hayek | Nurse Practitioner | 735 Glynn Street S, Fayetteville, GA 30215 | 2008-09-16 |
| 1174700769 | Katheryn D. Mcdonell | Counselor | 110 Dawn Drive, Fayetteville, GA 30215 | 2008-01-25 |
| Find all providers in zip 30215 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477189157 | Fatimat Olumayowa Olufunmilayo Agbojeyin | Nurse Practitioner | 105 Emerald Lake Ct, Fayetteville, GA 30215-7748 | 2020-03-13 |
| 1548821069 | Asic Behavioral Health, Pllc | Nurse Practitioner | 6977 Nexus Ct Ste 103, Fayetteville, NC 28304-2651 | 2019-06-25 |
| 1245794387 | Stacey Lasandra Mitchell | Nurse Practitioner | 1415 Highway 85 N Ste 310-390, Fayetteville, GA 30214-7738 | 2019-01-23 |
| 1417206491 | Casey J Scott | Nurse Practitioner | 4001 Cumberland Rd, Fayetteville, NC 28306-6703 | 2012-09-05 |
| 1972510519 | Melodie W. Stembridge | Nurse Practitioner | 1100 No. College Avenue, Vhsa, Fayetteville, AR 72703 | 2006-08-02 |
| 1053313536 | Margaret Jean Davis | Nurse Practitioner | 4276 Legend Avenue, Fayetteville, NC 28303-3497 | 2005-08-15 |
| 1811517469 | Ifeoma Nnani | Nurse Practitioner | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2020-04-23 |
| 1497380414 | Andrew Eisele | Nurse Practitioner | 1955 W Truckers Dr, Fayetteville, AR 72704-5637 | 2020-03-10 |
| 1417582545 | Latoya Harley-dowden | Nurse Practitioner | 806 Hay St, Fayetteville, NC 28305-5312 | 2020-03-09 |
| 1104459114 | Stephanie Bohannon | Nurse Practitioner | 112 W Center St Ste 201, Fayetteville, AR 72701-6073 | 2020-02-18 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30215 |
Please comment or provide details below to improve the information on TYRONE 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.