Individual provider Active NPI

Amanda Smith

  • Family Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1205614880
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11028656 Issued in FL
Practice address
601 5TH St S Ste 605
Saint Petersburg, FL 33701-4804
Phone
(727) 822-4300
NPI assigned
Sep 15, 2023
Last updated
Sep 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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 APRN11028656 FL Primary

Addresses

Primary practice location

601 5TH St S Ste 605
Saint Petersburg, FL 33701-4804

Mailing address

2901 58TH Ave N
Saint Petersburg, FL 33714-1326

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
I20241219001183 FL Practitioner - Nurse Practitioner 1850828567 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Gastroenterology Hepatology & Nutrition of FL P a CurrentSince Sep 17, 2023 Accepting new patients
Ivx Health of Florida, P.a. CurrentSince Nov 21, 2024 Accepting new patients
Pediatric Physician Services, Inc. Past Accepting new patients
Infusion Express of Kansas LLC Past Accepting new patients

Locations

293 E Altamonte Dr
Ste 1201
Altamonte Springs, FL 32701
Phone (407) 392-3171

25930 Sierra Center Blvd
Ste 9
Lutz, FL 33559
Phone (813) 337-0215

2901 58th Ave N
St Petersburg, FL 33714

601 5th St S
Ste 605
St Petersburg, FL 33701
Phone (727) 822-4300

601 5th St S
Ste C620
St Petersburg, FL 33701
Phone (727) 822-4300

10007 N Dale Mabry Hwy
Tampa, FL 33618
Phone (813) 265-2520

Interoperability endpoints

  • Direct secure messaging: asmith1221501@direct.hopkinsmedicine.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1205614880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 58TH AVE N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337141326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 5TH ST S STE 605",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337014804",
            "telephone_number": "727-822-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11028656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.