Individual provider Active NPI

Lara Nix Smith, MSN, RN

  • Registered Nurse
  • Monticello, FL
National Provider Identifier
1194312082
Registry record updated Dec 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN9388307 Issued in FL
Practice address
430 Willow St
Monticello, FL 32344-1037
Phone
(229) 200-4143
NPI assigned
Dec 24, 2020
Last updated
Dec 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9388307 FL Primary

Addresses

Primary practice location

430 Willow St
Monticello, FL 32344-1037

Mailing address

430 Willow St
Monticello, FL 32344-1037
Phone (229) 200-4143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN9388307FLMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1608768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608768000000",
    "number": "1194312082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 WILLOW ST",
            "city": "MONTICELLO",
            "state": "FL",
            "postal_code": "323441037",
            "telephone_number": "229-200-4143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 WILLOW ST",
            "city": "MONTICELLO",
            "state": "FL",
            "postal_code": "323441037",
            "telephone_number": "229-200-4143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LARA",
        "middle_name": "NIX",
        "credential": "MSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-24",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9388307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.