Active NPI
Mary T Smith, FNP
- Family Nurse Practitioner
- Flowood, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 668699
- Practice address
- 215 Katherine Dr Ste a
Flowood, MS 39232-9588 - Phone
- (601) 665-4162
- Fax
- (888) 398-1151
- NPI assigned
- Dec 14, 2006
- Last updated
- Oct 18, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 668699 | MS | Primary |
Addresses
Primary practice location
215 Katherine Dr Ste a
Flowood, MS 39232-9588
Mailing address
PO Box 4128
Meridian, MS 39304-4128
Phone (601) 581-7600
Other practice location 1
1818 College Drive
Meridian, MS 39307-5429
Phone (601) 581-7600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000119998 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 668699 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mississippi Band of Choctaw Indians | Current | Accepting new patients | |
| Mississippi Band of Choctaw Indians | Current | Accepting new patients | |
| Mississippi Band of Choctaw Indians | Current | Accepting new patients | |
| Mississippi Band of Choctaw Indians | Current | Accepting new patients | |
| Mississippi Band of Choctaw Indians | Current | Accepting new patients | |
| Anderson Physician Alliance, Inc. | Past | Accepting new patients |
Locations
1930 N Pearl St
Carthage, MS 39051
Phone (601) 287-6639
210 Hospital Cir
Choctaw, MS 39350
Phone (601) 389-4500
376 Campus Rd
Conehatta, MS 39057
Phone (601) 389-4500
124 Big Creek Cir
Philadelphia, MS 39350
Phone (601) 389-4500
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Conehatta Satellite Clinic
- Federal Public Health Clinic/Center
- Conehatta, MS
- NPI 1013092600
-
dba Bogue Chitto Satellite Clinic
- Federal Public Health Clinic/Center
- Philadelphia, MS
- NPI 1144305731
-
dba Red Water Satellite Clinic
- Federal Public Health Clinic/Center
- Carthage, MS
- NPI 1275611543
-
dba Choctaw Health Center Ambulance
- Ambulance
- Choctaw, MS
- NPI 1548358153
-
dba Choctaw Health Center
- General Acute Care Hospital
- Choctaw, MS
- NPI 1790865780
-
dba Baptist Medical Group-Anderson Physician Alliance
- Multi-Specialty Clinic/Center
- Meridian, MS
- NPI 1760798227
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697587200000",
"number": "1144382672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4128",
"city": "MERIDIAN",
"state": "MS",
"postal_code": "393044128",
"telephone_number": "601-581-7600",
"fax_number": "601-483-5543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 KATHERINE DR STE A",
"city": "FLOWOOD",
"state": "MS",
"postal_code": "392329588",
"telephone_number": "601-665-4162",
"fax_number": "888-398-1151"
}
],
"practiceLocations": [
{
"address_1": "1818 College Drive",
"address_purpose": "LOCATION",
"city": "Meridian",
"state": "MS",
"postal_code": "393075429",
"country_code": "US",
"telephone_number": "601-581-7600",
"fax_number": "601-483-5543",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "MARY",
"middle_name": "T",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-14",
"last_updated": "2023-10-18",
"certification_date": "2023-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "668699",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000119998",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Flowood, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.