Individual provider Active NPI

Bridgette Smith, NP

  • Family Nurse Practitioner
  • Marianna, FL
National Provider Identifier
1194477265
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11016694 Issued in FL
Practice address
4719 Highway 90
Marianna, FL 32446-7839
Phone
(850) 526-3314
Fax
(850) 526-5022
NPI assigned
Jan 20, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11016694 FL Primary

Addresses

Primary practice location

4719 Highway 90
Marianna, FL 32446-7839

Mailing address

4719 Highway 90
Marianna, FL 32446-7839
Phone (850) 526-3314

Other practice location 1

951 Prim Ave Ste 20
Graceville, FL 32440-2500
Phone (850) 360-4000

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
I20220208000040 FL Practitioner - Nurse Practitioner 1456744846 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caremed Clinic LLCGroup PAC ID 0446589469, 3 clinicians

Practice addresses (Care Compare)

4719 Hwy 90
Marianna, FL 32446-7839
Phone (850) 526-3314

Hospital & facility affiliations

  • Jackson Hospital Hospital, Marianna, FL, CCN 100142

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11016694FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Caremed Clinic LLC Family CurrentSince Feb 2, 2022 Accepting new patients
Caremed Urgent Care LLC Family CurrentSince Jun 30, 2022 Accepting new patients

Locations

951 Prim Ave
Ste 20
Graceville, FL 32440
Phone (850) 360-4000

4719 Highway 90
Marianna, FL 32446
Phone (850) 526-3314

7301 West Blvd
Ste A1
Youngstown, OH 44512

Interoperability endpoints

  • Direct secure messaging: bridgette.smith.1@20680.direct.athenahealth.com

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 and National Provider Directory roles.

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": "1642636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1194477265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4719 HIGHWAY 90",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324467839",
            "telephone_number": "850-526-3314",
            "fax_number": "850-526-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4719 HIGHWAY 90",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324467839",
            "telephone_number": "850-526-3314",
            "fax_number": "850-526-5022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "951 Prim Ave Ste 20",
            "address_purpose": "LOCATION",
            "city": "Graceville",
            "state": "FL",
            "postal_code": "324402500",
            "country_code": "US",
            "telephone_number": "850-360-4000",
            "fax_number": "850-759-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRIDGETTE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11016694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marianna, FL

Sources for this page

Verify at the official NPI Registry.