John D Smith III, CRNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

R871827 Issued in MS

Practice address

15190 Community Rd Ste 120
Gulfport, MS 39503-3484

Phone

(228) 205-6825

Fax

(228) 831-8782

NPI assigned

Sep 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Singing River Health SystemGroup PAC ID 3870405194, 290 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Singing River Health System Hospital, Pascagoula, MS, CCN 250040
• Singing River Gulfport Hospital, Gulfport, MS, CCN 250123

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 and National Provider Directory roles.

• Singing River Health System

  • Multi-Specialty Clinic/Center
  • Gautier, MS
  • NPI 1083893937
  Medicare reassignment Care Compare group NPD
• Singing River Gulfport

  dba Singing River Gulfport Ambulatory

  • Multi-Specialty Clinic/Center
  • Gulfport, MS
  • NPI 1861010159
  Medicare reassignment NPD
• Singing River Gulfport

  • Internal Medicine Physician
  • Gulfport, MS
  • NPI 1487327193
  NPD
• Singing River Health System

  dba Inpatient Physician Services

  • Internal Medicine Physician
  • Pascagoula, MS
  • NPI 1134283419
  NPD (past)

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

• Singing River Gulfport

  • General Acute Care Hospital
  • Gulfport, MS
  • NPI 1639797913
  Care Compare affiliation
• Singing River Health System

  • Multi-Specialty Clinic/Center
  • Gautier, MS
  • NPI 1083893937

  Hospital

  Care Compare affiliation
• Singing River Health System

  • General Acute Care Hospital
  • Pascagoula, MS
  • NPI 1124136593
  Care Compare affiliation

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1114021359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15190 COMMUNITY RD STE 120",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033484",
            "telephone_number": "228-205-6825",
            "fax_number": "228-831-8782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15190 COMMUNITY RD STE 120",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033484",
            "telephone_number": "228-205-6825",
            "fax_number": "228-831-8782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_suffix": "III",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-08",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "R871827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003101732",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC",
            "identifier": "5707330001",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elena C Smith
• Emily A Smith, P-LPC
• Forrest Smith
• Heather Michele Smith, PHD
• Jasmine L. Smith, LPC
• Joshua De'Von Smith, MA, DPC, LPC
• Joyce Smith, PCCSS
• Kelly A Smith, IDC
• Lisa Mabry Smith, MD
• Maggie Elizabeth Smith, DPT

• Acute Care Nurse Practitioner in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Acute Care Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.