Individual provider Active NPI

Taylor Michael Smith, PMHNP, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Beaumont, TX
National Provider Identifier
1194213025
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP135901 Issued in TX
Practice address
3515 Fannin St Ste 105
Beaumont, TX 77701-3810
Phone
(409) 735-2005
Fax
(409) 735-1246
NPI assigned
Apr 26, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP135901 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2021013683 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP135901 TX Primary

Addresses

Primary practice location

3515 Fannin St Ste 105
Beaumont, TX 77701-3810

Mailing address

3515 Fannin St Ste 105
Beaumont, TX 77701-3810
Phone (409) 735-2005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210706003501 TX Practitioner - Nurse Practitioner 8224430715 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Setx Psych PLLCGroup PAC ID 9638605942, 2 clinicians

Practice addresses (Care Compare)

3515 Fannin St
Suite 105
Beaumont, TX 77701-3810
Phone (409) 735-2005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021013683TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Newpath Group Psychiatric/Mental Health CurrentSince Dec 1, 2023 Accepting new patients
Setx Psych PLLC Psychiatric/Mental Health CurrentSince Oct 9, 2024 Accepting new patients
Edward B Gripon MD PA CurrentSince Jul 1, 2021 Accepting new patients
Winnie Community Hospital LLC Current Accepting new patients
Winnie Community Hospital, L.L.C. CurrentSince Jun 20, 2024 Accepting new patients
Winnie Community Hospital LLC CurrentSince Jun 20, 2024 Accepting new patients

Locations

3560 Delaware St
Ste 502
Beaumont, TX 77706
Phone (409) 899-4472

4749 Odom Rd
Beaumont, TX 77706
Phone (409) 200-2220

3515 Fannin St
Ste 105
Beaumont, TX 77701
Phone (409) 735-2005

105 Canyon Lake Cir
Lumberton, TX 77657
Phone (409) 200-2220

2400 Highway 365
Ste 112
Nederland, TX 77627
Phone (409) 724-7900

538 Broadway
Winnie, TX 77665
Phone (409) 296-6000

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.

NPI Registry JSON

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1194213025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 FANNIN ST STE 105",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777013810",
            "telephone_number": "409-735-2005",
            "fax_number": "409-735-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 FANNIN ST STE 105",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777013810",
            "telephone_number": "409-735-2005",
            "fax_number": "409-735-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TAYLOR",
        "middle_name": "MICHAEL",
        "credential": "PMHNP, FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-26",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP135901",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "2021013683",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP135901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.