Stephanie D. Smith, CFNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R865285 Issued in MS

Practice address

1101 Hwy 11 S
Ellisville, MS 39437-4443

Phone

(601) 477-5770

NPI assigned

Feb 13, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Calhoun Medical Clinic LLCGroup PAC ID 0941596084, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South Central Reg Med Ctr Hospital, Laurel, MS, CCN 250058

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/c57b8fef-3c95-4d31-a1ba-989525848740/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Calhoun Medical Clinic, LLC

  • Family Medicine Physician
  • Laurel, MS
  • NPI 1558713511

  MS

  Medicare reassignment Care Compare group NPD
• Hattiesburg Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Hattiesburg, MS
  • NPI 1164805156

  MS

  Medicare reassignment NPD
• Maxem Health Urgent Care Diberville

  • Urgent Care Clinic/Center
  • Diberville, MS
  • NPI 1265991608

  MS

  Medicare reassignment NPD
• Maxem Health Urgent Care Magee

  • Urgent Care Clinic/Center
  • Magee, MS
  • NPI 1235669136

  MS

  Medicare reassignment NPD
• Maxem Health Urgent Care McComb

  • Urgent Care Clinic/Center
  • McComb, MS
  • NPI 1235619479

  MS

  Medicare reassignment NPD
• Pascagoula Urgent Care

  • Urgent Care Clinic/Center
  • Pascagoula, MS
  • NPI 1235442872

  MS

  Medicare reassignment NPD
• Ocean Springs Urgent Care

  • Urgent Care Clinic/Center
  • Ocean Springs, MS
  • NPI 1871808022

  MS

  Medicare reassignment
• Orange Grove Urgent Care

  • Urgent Care Clinic/Center
  • Gulfport, MS
  • NPI 1831330661

  MS

  Medicare reassignment
• Petal Urgent Care LLC

  • Urgent Care Clinic/Center
  • Petal, MS
  • NPI 1982908877

  MS

  Medicare reassignment
• Picayune Urgent Care Clinic, LLC

  • Urgent Care Clinic/Center
  • Picayune, MS
  • NPI 1780723502

  MS

  Medicare reassignment
• Gulfport 49 Imaging, LLC

  • Radiology Clinic/Center
  • Gulfport, MS
  • NPI 1134702301
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Central Regional Medical Center

  • General Acute Care Hospital
  • Laurel, MS
  • NPI 1619973542

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234483200000",
    "number": "1003055005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 WATERTANK RD",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394432954",
            "telephone_number": "601-577-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 HWY 11 S",
            "city": "ELLISVILLE",
            "state": "MS",
            "postal_code": "394374443",
            "telephone_number": "601-477-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHANIE",
        "middle_name": "D.",
        "name_prefix": "Mrs.",
        "credential": "CFNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-13",
        "last_updated": "2009-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R865285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay Scoggin, RPH
• Shaffer Eye Clinic
• Shaffer'S Optical Express
• Courtney J. Sims, FNP-C
• Marilyn Smith, CIDDT
• South Central Clinics, Inc
• South Central Clinics, Inc.
• South Central Clinics, Inc.
• South Central Regional Medical Center
• South Central Regional Medical Center

• All providers in Ellisville, MS
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.