Jonathan Smith, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

904849 Issued in MS

Practice address

601 Brookman Dr Ext
Brookhaven, MS 39601-2371

Phone

(601) 823-5275

NPI assigned

Sep 9, 2021

Last updated

Jun 12, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kings Daughters Medical CenterGroup PAC ID 3072575539, 75 clinicians

KDMC Physician Clinics LLCGroup PAC ID 7012154495, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• King's Daughters Medical Center-Brookhaven Hospital, Brookhaven, MS, CCN 250057

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/6393/brand/1/csg/41/fhir/r4

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.

• KDMC Physician Clinics LLC

  • Multi-Specialty Clinic/Center
  • Brookhaven, MS
  • NPI 1861739161
  Medicare reassignment Care Compare group NPD
• Kings Daughters Medical Center

  dba Kings Daughters Pro Anesthesia

  • Anesthesiology Physician
  • Brookhaven, MS
  • NPI 1043245368

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• King's Daughters Medical Center

  dba King's Daughters Medical Equipment

  • Durable Medical Equipment & Medical Supplies
  • Brookhaven, MS
  • NPI 1881476364
  NPD
• King's Daughters Medical Center

  • General Acute Care Hospital
  • Brookhaven, MS
  • NPI 1972503464

  Multi-Specialty

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• King's Daughters Medical Center

  • General Acute Care Hospital
  • Brookhaven, MS
  • NPI 1972503464
  Care Compare affiliation

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1205505666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 HIGHWAY 51 N",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012350",
            "telephone_number": "601-833-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 BROOKMAN DR EXT",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012371",
            "telephone_number": "601-823-5275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JONATHAN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-09",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cecilia Smith, COTA
• Chad P Smith, O.D.
• David Anthony Smith, MSN, PMHNP-BC
• Hollie Christina Smith, BSN, RN
• Jennifer D Smith, FNP
• Joseph Reid Smith, ACNPC-AG
• Kariean Smith, LPC-S
• Kia C Smith, M.REL, PCMHT
• Lesleye L Smith, CCC-A
• Manerva Angelica Smith

• Family Nurse Practitioner in Brookhaven, MS
• Providers in Brookhaven, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.