Individual provider Active NPI

Ronald Ray Smith, APRN

  • Acute Care Nurse Practitioner
  • Decherd, TN
National Provider Identifier
1174740047
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
12132 Issued in TN
Practice address
520 Warren Chapel Rd
Decherd, TN 37324-3937
Phone
(931) 962-5060
Fax
(931) 962-5162
NPI assigned
Apr 20, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 12132 TN Primary

Addresses

Primary practice location

520 Warren Chapel Rd
Decherd, TN 37324-3937

Mailing address

1503 N Jackson St
Tullahoma, TN 37388-2343
Phone (615) 594-9144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20121113000347 TN Practitioner - Nurse Practitioner 9133370562 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anova Medical Associates, PLCGroup PAC ID 8325372741, 130 clinicians

Practice addresses (Care Compare)

1156 Nashville Pike
Gallatin, TN 37066-3110
Phone (615) 989-1088

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
App of Tennessee HM, PLLC CurrentSince Aug 5, 2019 Accepting new patients
Apogee Medical Group Tennessee PC CurrentSince Sep 2, 2012 Accepting new patients
Anova Medical Associates, PLC CurrentSince Jul 1, 2022 Accepting new patients

Locations

1156 Nashville Pike
Gallatin, TN 37066
Phone (615) 989-1088

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

2835 Highway 231 N
Shelbyville, TN 37160
Phone (931) 685-5433

1801 N Jackson St
Tullahoma, TN 37388
Phone (931) 393-3000

Interoperability endpoints

  • Direct secure messaging: rsmith659245@direct.vumc.org

Organizations & group practices 3

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 2

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": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174740047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 N JACKSON ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882343",
            "telephone_number": "615-594-9144",
            "fax_number": "931-962-5162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 WARREN CHAPEL RD",
            "city": "DECHERD",
            "state": "TN",
            "postal_code": "373243937",
            "telephone_number": "931-962-5060",
            "fax_number": "931-962-5162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RONALD",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "12132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decherd, TN

Sources for this page

Verify at the official NPI Registry.