Individual provider Active NPI

Sondra Smith, ARNP

  • Nurse Practitioner
  • Homestead, FL
National Provider Identifier
1164759957
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9203820 Issued in FL
Practice address
810 W Mowry Dr
Homestead, FL 33030-5746
Phone
(305) 248-4334
Fax
(305) 245-1161
NPI assigned
Nov 16, 2009
Last updated
Sep 14, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9203820 FL Primary

Addresses

Primary practice location

810 W Mowry Dr
Homestead, FL 33030-5746

Mailing address

810 W Mowry Dr
Homestead, FL 33030-5746
Phone (305) 248-4334

Other identifiers 1

IdentifierTypeStateIssuer
001642600MedicaidFL

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
I20100326000417 FL Practitioner - Nurse Practitioner 2163558347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Practice addresses (Care Compare)

11392 E Hwy 316
Fort McCoy, FL 32134-8114
Phone (352) 236-0440

3845 SE Lake Weir Ave
Cora Physical Therapy East Ocala
Ocala, FL 34480-9153
Phone (352) 693-3378

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Breen Health, LLC CurrentSince Jan 27, 2018 Accepting new patients

Locations

11392 E Highway 316
Fort Mc Coy, FL 32134
Phone (352) 236-0440

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Community Family Health CareFort MC Coy, FL, CCN 683830 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
W-2 Managing Employee (100%)
Jan 1, 2020
Jan 1, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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.

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": "1258329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1164759957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 W MOWRY DR",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330305746",
            "telephone_number": "305-248-4334",
            "fax_number": "305-245-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W MOWRY DR",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330305746",
            "telephone_number": "305-248-4334",
            "fax_number": "305-245-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SONDRA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-16",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9203820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001642600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

Verify at the official NPI Registry.