Carolyn Rena Smith

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

LG-0012438 Issued in DE

Practice address

1624 Jessup St
Wilmington, DE 19802-4210

Phone

(302) 552-3574

NPI assigned

Aug 25, 2023

Sex

Female

Sole proprietor

No

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 DE, PA, NH3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Daniel Funsch Jr MD PCGroup PAC ID 1951801836, 139 clinicians

Ivy Medical Group PLLCGroup PAC ID 4981097797, 120 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: csmith526606@wellspan.direct-ci.com

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.

• Daniel Funsch Jr, M.D., P.C.

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1316784580

  PA

  Medicare reassignment Care Compare group NPD
• Ivy Medical Group PLLC

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1700558798

  DE, NH, PA

  Medicare reassignment Care Compare group NPD
• The Life Center Complex, Inc

  • Community Health Clinic/Center
  • Wilmington, DE
  • NPI 1770808578
  Medicare reassignment NPD
• Dr Rebman BH LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • New York, NY
  • NPI 1114894540

  DE, NH, PA

  Medicare reassignment NPD
• Dr Rebman Medical PA

  • Family Medicine Physician
  • Miami, FL
  • NPI 1669276689

  DE, PA

  Medicare reassignment NPD
• The Life Center Complex, Inc

  • Student Health Clinic/Center
  • Wilmington, DE
  • NPI 1366114522
  NPD
• The Life Center Complex, Inc.

  • Student Health Clinic/Center
  • Dover, DE
  • NPI 1609590538
  NPD
• Wellspan Medical Group

  • Pediatric Surgery Physician
  • York, PA
  • NPI 1104799428
  NPD
• Wellspan Medical Group

  • Family Medicine Physician
  • East Berlin, PA
  • NPI 1649348525
  NPD
• Wellspan Medical Group

  • Gastroenterology Physician
  • York, PA
  • NPI 1669770004
  NPD

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1023893393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BANCROFT RD",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197208848",
            "telephone_number": "215-834-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 JESSUP ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198024210",
            "telephone_number": "302-552-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CAROLYN",
        "middle_name": "RENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0012438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alana Smith, L.M.T., M.M.P
• Angela Dorman Smith, MD
• Ashleigh Smith, RN
• Brett T Smith, PHARMD
• Caitlyn Elizabeth Smith, DO
• Christian Rex Smith, RPH
• Clifford O. Smith, PH.D.
• Courtney Smith
• Danielle K Smith
• Dolores Smith

• Family Nurse Practitioner in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Family Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.