Individual provider Active NPI

Aimee Davis Smith, PA-C

  • Physician Assistant
  • Nashville, TN
National Provider Identifier
1073863486
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0000004028 Issued in TN
Practice address
4301 Hillsboro Pike
Nashville, TN 37215-3345
Phone
(615) 383-6092
Fax
(615) 292-8424
NPI assigned
Sep 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA0000004028 TN Primary

Addresses

Primary practice location

4301 Hillsboro Pike
Nashville, TN 37215-3345

Mailing address

5512 Oakmont Cir
Nashville, TN 37209-4635
Phone (615) 653-9003

Other identifiers 1

IdentifierTypeStateIssuer
007271000MedicaidFL

Other names 1

  • Aimee Marie Davis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20121120000409 FL Practitioner - Physician Assistant 8022269133 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA0000004028TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Florida Dermatology Associates P.a. CurrentSince Nov 1, 2012 Accepting new patients

Locations

100 W Gore St
Ste 602
Orlando, FL 32806
Phone (407) 839-3999

7652 Ashley Park Ct
Ste 305
Orlando, FL 32835
Phone (407) 839-0127

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": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1073863486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5512 OAKMONT CIR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372094635",
            "telephone_number": "615-653-9003",
            "fax_number": "615-292-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 HILLSBORO PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372153345",
            "telephone_number": "615-383-6092",
            "fax_number": "615-292-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AIMEE",
        "middle_name": "DAVIS",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-12",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA0000004028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007271000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AIMEE",
            "last_name": "DAVIS",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.