Individual provider Active NPI

Andrea Lynn Smith, FNP-C

  • Family Nurse Practitioner
  • Richardson, TX
National Provider Identifier
1205089877
Registry record updated Nov 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
694424 Issued in TX
Practice address
399 W. Campbell Rd, Suite 400
Richardson, TX 75080
Phone
(972) 498-4389
Fax
(972) 238-0455
NPI assigned
Oct 28, 2008
Last updated
Nov 11, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2010

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 694424 TX Primary

Addresses

Primary practice location

399 W. Campbell Rd, Suite 400
Richardson, TX 75080

Mailing address

399 W. Campbell Rd, Suite 400
Richardson, TX 75080
Phone (972) 498-4389

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

State licenses

LicenseStateTypeSpecialty
694424TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289433600000",
    "number": "1205089877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 W. CAMPBELL RD, SUITE 400",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "75080",
            "telephone_number": "972-498-4389",
            "fax_number": "972-238-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 W. CAMPBELL RD, SUITE 400",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "75080",
            "telephone_number": "972-498-4389",
            "fax_number": "972-238-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANDREA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2010-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "694424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; 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.