Individual provider Active NPI

Lynda M Smith, MSN, FNP

  • Family Nurse Practitioner
  • Collegedale, TN
National Provider Identifier
1053428516
Registry record updated Aug 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11775 Issued in TN
Practice address
5121 Ooltewah-Ringgold Road
Suite G
Collegedale, TN 37315
Phone
(423) 238-0033
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11775 TN Primary

Addresses

Primary practice location

5121 Ooltewah-Ringgold Road
Suite G
Collegedale, TN 37315

Mailing address

PO Box 793
Ooltewah, TN 37363-0793
Phone (423) 238-0033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070126000598 TN Practitioner - Nurse Practitioner 8527069970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McKenzie Center for Internal Medicine, PLLC Current Accepting new patients
Brookside Medical Center PLLC Past Accepting new patients

Locations

6031 Shallowford Rd
Ste 105
Chattanooga, TN 37421
Phone (423) 468-3923

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1053428516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 793",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373630793",
            "telephone_number": "423-238-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 OOLTEWAH-RINGGOLD ROAD",
            "address_2": "SUITE G",
            "city": "COLLEGEDALE",
            "state": "TN",
            "postal_code": "37315",
            "telephone_number": "423-238-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LYNDA",
        "middle_name": "M",
        "credential": "MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "11775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collegedale, TN

Sources for this page

Verify at the official NPI Registry.