Theodean Smith-Lawrence, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

345477 Issued in NY

Practice address

147 Lake St
Newburgh, NY 12550-5263

Phone

(845) 563-8000

NPI assigned

Sep 3, 2020

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cornerstone Family HealthcareGroup PAC ID 4880610393, 67 clinicians

Anderson Medical PC Dba Emergency OneGroup PAC ID 0648161653, 22 clinicians

Sun River Health Inc.Group PAC ID 6608783568, 246 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DGCECD
• FHIR API: https://fhir4.healow.com/fhir/r4/DGCECD/Endpoint/DGCECD

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.

• Cornerstone Family Healthcare

  • Federally Qualified Health Center (FQHC)
  • Newburgh, NY
  • NPI 1689669079
  Medicare reassignment Care Compare group NPD
• Sun River Health Inc

  • Federally Qualified Health Center (FQHC)
  • Amenia, NY
  • NPI 1568526838
  Medicare reassignment Care Compare group NPD
• Anderson Medical P.C. Dba Emergency One

  • Urgent Care Clinic/Center
  • Kingston, NY
  • NPI 1114043411
  Medicare reassignment Care Compare group
• Cornerstone Family Healthcare

  • Federally Qualified Health Center (FQHC)
  • Newburgh, NY
  • NPI 1114757515
  NPD
• Sun River Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Peekskill, NY
  • NPI 1619969458
  NPD

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1003420472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 ROUTE 9W STE 10",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181370",
            "telephone_number": "845-220-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 LAKE ST",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125505263",
            "telephone_number": "845-563-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-LAWRENCE",
        "first_name": "THEODEAN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-03",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "345477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06447401",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nia Slaughter
• Small Smiles Dentistry of Newburgh, LLC
• Erin Leigh Small, MA, CASAC-T
• Smile Dentist P.C.
• Smileworks Dental of the Hudson Valley
• Alicia Maria Smith
• Amanda R Smith, LCSW
• Bonnie Smith, CRNA
• Percy Smith
• Yvette Elizabeth Smith, CASAC

• Family Nurse Practitioner in Newburgh, NY
• Providers in Newburgh, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.