Active NPI
Yolanda Smith
- Adult Health Nurse Practitioner
- Jackson, MS
National Provider Identifier
1043545874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- R881874
- Practice address
- 1040 River Oaks Dr
Suite 302
Jackson, MS 39232-9530 - Phone
- (601) 939-9923
- NPI assigned
- Oct 13, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | R881874 | MS | Primary |
Addresses
Primary practice location
1040 River Oaks Dr
Suite 302
Jackson, MS 39232-9530
Mailing address
3322 W End Ave
11TH Floor
Nashville, TN 37203-1031
Phone (615) 515-9880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180904000502 | SC | Practitioner - Nurse Practitioner | 1759414436 | Practice locations: Chapin, SC |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R881874 | MS | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindcare Solutions PC | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/19201/brand/1/csg/1/fhir/r4
Organizations & group practices 1
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.
-
- Psychiatry Physician
- Nashville, TN
- NPI 1457015091
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394323200000",
"number": "1043545874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3322 W END AVE",
"address_2": "11TH FLOOR",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372031031",
"telephone_number": "615-515-9880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 RIVER OAKS DR",
"address_2": "SUITE 302",
"city": "JACKSON",
"state": "MS",
"postal_code": "392329530",
"telephone_number": "601-939-9923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "YOLANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-13",
"last_updated": "2014-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MS",
"license": "R881874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2014; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.