Individual provider Active NPI

Tina A. Smith, APRN

  • Family Nurse Practitioner
  • Stanton, KY
National Provider Identifier
1073087797
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3013143 Issued in KY
Practice address
638 E College Ave Ste B
Stanton, KY 40380-2363
Phone
(606) 318-3500
Fax
(606) 318-3503
NPI assigned
Jan 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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 3013143 KY Primary

Addresses

Primary practice location

638 E College Ave Ste B
Stanton, KY 40380-2363

Mailing address

638 E College Ave Ste B
Stanton, KY 40380-2363
Phone (606) 318-3500

Other practice location 1

3193 Fairground Ridge Rd
Beattyville, KY 41311-8502
Phone (606) 560-3122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20190717001965 KY Practitioner - Nurse Practitioner 5496080137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Clinics of Kentucky LLCGroup PAC ID 2668457094, 15 clinicians

Practice addresses (Care Compare)

1060 Grand Ave
Beattyville, KY 41311-9104
Phone (606) 464-0108

219 Mountain Pkwy Spur Rd
Campton, KY 41301-8988
Phone (606) 668-3120

Hospital & facility affiliations

  • Morgan County Arh Hospital Hospital, West Liberty, KY, CCN 181307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
United Clinics of Kentucky LLC CurrentSince Jun 10, 2019 Accepting new patients
United Clinics of Kentucky LLC CurrentSince Jun 10, 2019 Accepting new patients
United Clinics of Kentucky LLC Past Accepting new patients
United Clinics of Kentucky LLC Past Accepting new patients

Locations

1060 Grand Ave
Beattyville, KY 41311
Phone (606) 464-0108

95 Jackson Hts
Ste A
Jackson, KY 41339
Phone (606) 718-6505

638 E College Ave
#B
Stanton, KY 40380
Phone (606) 318-3500

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1073087797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 E COLLEGE AVE STE B",
            "city": "STANTON",
            "state": "KY",
            "postal_code": "403802363",
            "telephone_number": "606-318-3500",
            "fax_number": "606-318-3506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 E COLLEGE AVE STE B",
            "city": "STANTON",
            "state": "KY",
            "postal_code": "403802363",
            "telephone_number": "606-318-3500",
            "fax_number": "606-318-3503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3193 Fairground Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Beattyville",
            "state": "KY",
            "postal_code": "413118502",
            "country_code": "US",
            "telephone_number": "606-560-3122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TINA",
        "middle_name": "A.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-15",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3013143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanton, KY

Sources for this page

Verify at the official NPI Registry.