Individual provider Active NPI

Brettanie Nicole Smidt, FNP-C

  • Registered Nurse
  • Pensacola, FL
National Provider Identifier
1124854609
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN9477609 Issued in FL
Practice address
1400 N Palafox St
Pensacola, FL 32501-2643
Phone
(850) 444-9449
NPI assigned
Sep 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11035360 FL
Registered Nurse 163W00000X RN9477609 FL Primary

Addresses

Primary practice location

1400 N Palafox St
Pensacola, FL 32501-2643

Mailing address

10175 Crest Ridge Dr
Pensacola, FL 32514-2616
Phone (928) 399-9916

Other names 1

  • Brettanie Nicole Block Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20241105002264 FL Practitioner - Nurse Practitioner 9436683059 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Escambia Community Clinics IncGroup PAC ID 9638165806, 36 clinicians

Practice addresses (Care Compare)

2315 W Jackson St
Pensacola, FL 32505-7552
Phone (850) 436-4630

6671 Caroline St
Milton, FL 32570-4781
Phone (850) 891-9433

Hospital & facility affiliations

  • Baptist Hospital Hospital, Pensacola, FL, CCN 100093

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9477609FLMDRegistered Nurse
APRN11035360FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Escambia Community Clinics, Inc CurrentSince Oct 21, 2024 Accepting new patients
Escambia Community Clinics Inc CurrentSince Oct 21, 2024 Accepting new patients
Escambia Community Clinics Inc Current Accepting new patients
Regional Healthcare Group LLC CurrentSince Oct 21, 2024 Accepting new patients
Guardian Biologics LLC CurrentSince Oct 21, 2024 Accepting new patients
Escambia Community Clinics, Inc Past Accepting new patients

Locations

6021 Industrial Blvd
Century, FL 32535
Phone (850) 724-4064

6671 Caroline St
Milton, FL 32570
Phone (850) 564-7722

5520 Stewart St
Milton, FL 32570
Phone (850) 891-9433

350 W Herman St
Pensacola, FL 32505
Phone (850) 332-5900

1400 N Palafox St
Pensacola, FL 32501
Phone (850) 444-9449

2315 W Jackson St
Pensacola, FL 32505
Phone (850) 495-3955

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1124854609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10175 CREST RIDGE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325142616",
            "telephone_number": "928-399-9916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N PALAFOX ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325012643",
            "telephone_number": "850-444-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMIDT",
        "first_name": "BRETTANIE",
        "middle_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11035360",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9477609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRETTANIE",
            "last_name": "BLOCK",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.