Nichole M Smith, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA02319 Issued in TX

Practice address

7200 Wyoming SPGS
Suite 600
Round Rock, TX 78681-4303

Phone

(512) 244-1995

Fax

(512) 244-2090

NPI assigned

Mar 13, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Family Medicine Associates of Round Rock, P.a.

  • Family Medicine Physician
  • Round Rock, TX
  • NPI 1730181793
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053444679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 WYOMING SPGS",
            "address_2": "SUITE 600",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814303",
            "telephone_number": "512-244-1995",
            "fax_number": "512-244-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 WYOMING SPGS",
            "address_2": "SUITE 600",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814303",
            "telephone_number": "512-244-1995",
            "fax_number": "512-244-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICHOLE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "PA02319",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kennedy Smith
• Laportia Smith, MD, MPH
• Meghan Ann Smith, FNP
• Michael Dale Smith, DDS
• Mika Smith, LPC
• Randi Marie Smith
• Roger Allen Smith, M.D.
• Ryan Smith, LCDC
• Scott A. Smith, M.D.
• Tonea Smith

• Physician Assistant in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.