Individual provider Active NPI

Cecily Robin Smith, NP

  • Nurse Practitioner
  • Gastonia, NC
National Provider Identifier
1013206911
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
160288 Issued in NC
Practice address
815 Cox Rd
Gastonia, NC 28054-3453
Phone
(704) 865-1700
Fax
(704) 865-7948
NPI assigned
Mar 31, 2011
Last updated
Oct 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 160288 NC Primary
Nurse Practitioner 363L00000X 990018 CO

Addresses

Primary practice location

815 Cox Rd
Gastonia, NC 28054-3453

Mailing address

815 Cox Rd
Gastonia, NC 28054-3453
Phone (704) 865-1700

Other practice location 1

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-2820

Other identifiers 1

IdentifierTypeStateIssuer
73884766MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20150930003339 NC Practitioner - Nurse Practitioner 8022296854 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

815 Cox Rd
Gastonia, NC 28054-3453
Phone (704) 865-1700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
990018COMDNurse Practitioner
160288NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Moses Cone Physician Services, Inc. CurrentSince Oct 16, 2023 Accepting new patients
Caromont Medical Group Inc Current Accepting new patients
Moses Cone Physician Services, Inc. Nurse Practitioner Current Accepting new patients
Caromont Medical Group Inc CurrentSince Jul 1, 2015 Accepting new patients
Moses Cone Physician Services Inc CurrentSince Oct 16, 2023 Accepting new patients
Caromont Medical Group Inc CurrentSince Jul 1, 2015 Accepting new patients

Locations

815 Cox Rd
Gastonia, NC 28054
Phone (704) 865-1700

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

Organizations & group practices 6

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1013206911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 COX RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280543453",
            "telephone_number": "704-865-1700",
            "fax_number": "704-865-7948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 COX RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280543453",
            "telephone_number": "704-865-1700",
            "fax_number": "704-865-7948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N Elm St",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274011004",
            "country_code": "US",
            "telephone_number": "336-832-2820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CECILY",
        "middle_name": "ROBIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-31",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "160288",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "990018",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "73884766",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.