Individual provider Active NPI

Tara N Smith, FNP-BC

  • Family Nurse Practitioner
  • Columbus, GA
National Provider Identifier
1093989733
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN128471 Issued in GA
Practice address
705 17TH St
Suite 106
Columbus, GA 31901-3500
Phone
(706) 321-3760
Fax
(706) 321-3763
NPI assigned
Apr 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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 RN128471 GA Primary

Addresses

Primary practice location

705 17TH St
Suite 106
Columbus, GA 31901-3500

Mailing address

PO Box 1038
Columbus, GA 31902-1038
Phone (706) 321-3760

Other identifiers 1

IdentifierTypeStateIssuer
2006004249-22OtherANCC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160510002481 GA Practitioner - Nurse Practitioner 1355630625 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Ambulatory Healthcare Services, Inc. CurrentSince Apr 18, 2016 Accepting new patients
Columbus Ambulatory Healthcare Services, Inc. CurrentSince Apr 18, 2016 Accepting new patients

Locations

1800 10th Ave
Columbus, GA 31901
Phone (706) 571-1120

705 17th St
Ste 106
Columbus, GA 31901
Phone (706) 289-5982

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": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1093989733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1038",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319021038",
            "telephone_number": "706-321-3760",
            "fax_number": "706-321-3763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 17TH ST",
            "address_2": "SUITE 106",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319013500",
            "telephone_number": "706-321-3760",
            "fax_number": "706-321-3763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TARA",
        "middle_name": "N",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-14",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN128471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC",
            "identifier": "2006004249-22",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.