Individual provider Active NPI

Melynda Whitmer Smith, N.P.

  • Family Nurse Practitioner
  • Cary, NC
National Provider Identifier
1114042892
Registry record updated Jan 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5011157 Issued in NC
Practice address
3600 Northwest Cary Pkwy.
Suite 104
Cary, NC 27513-8457
Phone
(781) 721-4616
NPI assigned
Mar 20, 2007
Last updated
Jan 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2023

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 5011157 NC Primary

Addresses

Primary practice location

3600 Northwest Cary Pkwy.
Suite 104
Cary, NC 27513-8457

Mailing address

3600 NW Cary Pkwy Ste 104
Cary, NC 27513-8444
Phone (919) 319-9219

Other identifiers 1

IdentifierTypeStateIssuer
200935410MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190614002328 NC Practitioner - Nurse Practitioner 2668533472

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3600 NW Cary Pkwy
Suite 104
Cary, NC 27513-8444

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5011157NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avance Care, PA CurrentSince Apr 1, 2022 Accepting new patients
Winchester Physician Associates Past Accepting new patients

Locations

115 Crescentcommons Dr
Ste 100
Cary, NC 27518
Phone (919) 467-5678

3600 NW Cary Pkwy
Ste 104
Cary, NC 27513
Phone (919) 319-9219

7510 Ramble Way
Ste 107
Raleigh, NC 27616
Phone (919) 277-8880

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673136000000",
    "number": "1114042892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 NW CARY PKWY STE 104",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138444",
            "telephone_number": "919-319-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 NORTHWEST CARY PKWY.",
            "address_2": "SUITE 104",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138457",
            "telephone_number": "781-721-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MELYNDA",
        "middle_name": "WHITMER",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2023-01-08",
        "certification_date": "2023-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5011157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200935410",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.