Individual provider Active NPI

Dana Nichols Smith, PNP

  • Pediatric Nurse Practitioner
  • Greenville, NC
National Provider Identifier
1023446424
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5006483 Issued in NC
Practice address
2150 Herbert CT
Ecu Physicians Pediatric Endocrinology
Greenville, NC 27834-3736
Phone
(252) 744-5437
Fax
(252) 744-1514
NPI assigned
Oct 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 5006483 NC Primary

Addresses

Primary practice location

2150 Herbert CT
Ecu Physicians Pediatric Endocrinology
Greenville, NC 27834-3736

Mailing address

PO Box 751069
Charlotte, NC 28275-1069

Other identifiers 1

IdentifierTypeStateIssuer
1023446424MedicaidNC

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
I20140105000002 NC Practitioner - Nurse Practitioner 7416185020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5006483NCMDPediatric Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: dsmith54642@direct.ecuhealth.com

NPI Registry JSON

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

{
    "created_epoch": "1382400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1023446424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751069",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 HERBERT CT",
            "address_2": "ECU PHYSICIANS PEDIATRIC ENDOCRINOLOGY",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343736",
            "telephone_number": "252-744-5437",
            "fax_number": "252-744-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DANA",
        "middle_name": "NICHOLS",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-22",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5006483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023446424",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.