Healthcare Provider Details

I. General information

NPI: 1528157211
Provider Name (Legal Business Name): JOHNSTON COUNTY PUBLIC HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 N BRIGHTLEAF BLVD
SMITHFIELD NC
27577-4407
US

IV. Provider business mailing address

517 N BRIGHTLEAF BLVD
SMITHFIELD NC
27577-4407
US

V. Phone/Fax

Practice location:
  • Phone: 919-989-5200
  • Fax: 919-989-5208
Mailing address:
  • Phone: 919-989-5200
  • Fax: 919-989-5208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number StateNC
# 7
Primary TaxonomyY
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number StateNC
# 8
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNC
# 9
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateNC

VIII. Authorized Official

Name: TANYA KAY SMITH
Title or Position: INFORMATION PROCESSING TECH
Credential:
Phone: 919-989-5539