Shatera Nicole Smith, APRN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

11015019 Issued in FL

Practice address

1125 Miranda LN
Kissimmee, FL 34741-0763

Phone

(689) 204-0153

NPI assigned

Oct 22, 2021

Last updated

May 25, 2022By the provider in NPPES

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 FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Legacy Family Medicine LLC

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1477878940
  Medicare reassignment NPD
• Mid-South Home Care Services, LLC

  dba Empatia Palliative Care

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Miami, FL
  • NPI 1174156210
  Medicare reassignment NPD
• Mid-South Home Care Services, LLC

  dba Empatia Palliative Care

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Winter Garden, FL
  • NPI 1679195028
  NPD
• Mid-South Home Care Services, LLC

  dba Empatia Palliative Care

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Alpharetta, GA
  • NPI 1154207769
  NPD
• Medi Winter Park LLC

  • General Practice Physician
  • Winter Park, FL
  • NPI 1588086953
  NPD (past)

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

{
    "created_epoch": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1073277406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 MIRANDA LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347410763",
            "telephone_number": "689-204-0153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 MIRANDA LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347410763",
            "telephone_number": "689-204-0153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6769 Rubens Ct",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328181344",
            "country_code": "US",
            "telephone_number": "407-443-0596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHATERA",
        "middle_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-22",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11015019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren E Smith
• Maria Smith
• Nikeda Smith, PA-C
• Octavia Leah Smith, MSW
• Sharon Denise Smith, APRN
• Shayna Smith
• Shelly-Ann O Smith
• Stephanie M Smith
• Taylor Smith
• Todd C. Smith, CRNA

• Gerontology Nurse Practitioner in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Gerontology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.