Individual provider Active NPI

Anne L Smith, N.P.

  • Nurse Practitioner
  • Augusta, GA
National Provider Identifier
1184732786
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN082793 Issued in GA
Practice address
1120 15TH St
Augusta, GA 30912-0004
Phone
(706) 724-6100
NPI assigned
Aug 25, 2006
Last updated
Nov 3, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2609 SC
Nurse Practitioner 363L00000X RN082793 GA Primary

Addresses

Primary practice location

1120 15TH St
Augusta, GA 30912-0004

Mailing address

1499 Walton Way
Ste. 1400
Augusta, GA 30901-2602
Phone (706) 724-6100

Other identifiers 1

IdentifierTypeStateIssuer
003130635BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20131204001108 GA Practitioner - Nurse Practitioner 2163431826 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2609SCMDChiropractor
RN082793GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Oct 1, 2013 Accepting new patients
Au Medical Associates Inc CurrentSince Oct 1, 2013 Accepting new patients

Locations

1499 Walton Way
Ste 1400
Augusta, GA 30901
Phone (706) 721-4951

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1184732786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 WALTON WAY",
            "address_2": "STE. 1400",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012602",
            "telephone_number": "706-724-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-724-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANNE",
        "middle_name": "L",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "2609",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN082793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003130635B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.