Individual provider Active NPI

Rachel Amanda Smith, FNP-BC

  • Family Nurse Practitioner
  • Flint, MI
National Provider Identifier
1114496445
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704253768 Issued in MI
Practice address
2700 Robert T Longway Blvd Ste B
Flint, MI 48503-2190
Phone
(810) 235-2004
NPI assigned
Nov 15, 2018
Last updated
Nov 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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 4704253768 MI Primary

Addresses

Primary practice location

2700 Robert T Longway Blvd Ste B
Flint, MI 48503-2190

Mailing address

312 E Kinsel Hwy
Charlotte, MI 48813-9785
Phone (810) 235-2004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20190124003710 MI Practitioner - Nurse Practitioner 2264779511 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704253768MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Coverage Services PC CurrentSince Dec 22, 2018 Accepting new patients
Lansing Urgent Care, PLC PastSince Nov 23, 2021 Accepting new patients

Locations

2700 Robert T Longway Blvd
Ste B
Flint, MI 48503
Phone (810) 235-2004

Interoperability endpoints

  • Direct secure messaging: rsmith80453@direct.hurleymc.com

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": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1114496445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 E KINSEL HWY",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488139785",
            "telephone_number": "810-235-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 ROBERT T LONGWAY BLVD STE B",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032190",
            "telephone_number": "810-235-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RACHEL",
        "middle_name": "AMANDA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704253768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.