Active NPI
Melissa Brooks Smith, LCSW
- Clinical Social Worker
- Tyndall Afb, FL
National Provider Identifier
1093053282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW 13405
- Practice address
- 325 MDG, 340 Magnolia Circle
Tyndall Afb, FL 32403-5604 - Phone
- (850) 283-7090
- NPI assigned
- Jan 22, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW 13405 | FL | Primary |
Addresses
Primary practice location
325 MDG, 340 Magnolia Circle
Tyndall Afb, FL 32403-5604
Mailing address
525 E 15TH St
Panama City, FL 32405-5412
Phone (850) 522-4485
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW 13405 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Compass Health, Inc | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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": "1358812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560470400000",
"number": "1093053282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 E 15TH ST",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324055412",
"telephone_number": "850-522-4485",
"fax_number": "850-522-4484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 MDG, 340 MAGNOLIA CIRCLE",
"city": "TYNDALL AFB",
"state": "FL",
"postal_code": "324035604",
"telephone_number": "850-283-7090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "MELISSA",
"middle_name": "BROOKS",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-22",
"last_updated": "2019-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW 13405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyndall Afb, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.