Individual provider Active NPI

Jennifer Nicole Smith, APRN

  • Nurse Practitioner
  • Texarkana, TX
National Provider Identifier
1215468897
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP142542 Issued in TX
Practice address
5904 Summerfield Dr
Texarkana, TX 75503-4306
Phone
(430) 200-4350
Fax
(855) 903-3930
NPI assigned
Mar 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP142542 TX
Nurse Practitioner 363L00000X AP142542 TX Primary

Addresses

Primary practice location

5904 Summerfield Dr
Texarkana, TX 75503-4306

Mailing address

5904 Summerfield Dr
Texarkana, TX 75503-4306
Phone (430) 200-4350

Other practice location 1

6201 Harry Hines Blvd
Dallas, TX 75390
Phone (214) 633-5555

Other practice location 2

2999 Olympus Blvd
Coppell, TX 75019-0122
Phone (469) 647-4445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20191008001100 TX Practitioner - Nurse Practitioner 6103194758 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Midsouth Homecare PLLCGroup PAC ID 3173051091, 7 clinicians
University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians
Midsouth Transitions Medical GroupGroup PAC ID 8628322831, 17 clinicians

Practice addresses (Care Compare)

Texarkana, TX 75503
Phone (430) 200-4350

2001 Inwood Rd
Dallas, TX 75390-7202
Phone (214) 645-0538

5904 Summerfield Dr
Texarkana, TX 75503-4306
Phone (430) 200-4350

Hospital & facility affiliations

  • Vitalcaring Group Home health agency, Sulphur Springs, TX, CCN 679076
  • Paradigm Homecare Home health agency, Tyler, TX, CCN 457833
  • Enhabit Home Health Home health agency, Tyler, TX, CCN 459457

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP142542TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 19, 2019 Accepting new patients
Midsouth Transitions Medical Group Family CurrentSince Sep 25, 2023 Accepting new patients
Midsouth Homecare PLLC Family CurrentSince Jan 1, 2025 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 19, 2019 Accepting new patients

Locations

2999 Olympus Blvd
Coppell, TX 75019
Phone (469) 647-4250

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

3621 22nd St
Ste 400
Lubbock, TX 79410
Phone (806) 791-8484

5904 Summerfield Dr
Texarkana, TX 75503
Phone (430) 200-4350

2001 Inwood Rd
Ut Southwest Medical Center, TX 75390
Phone (214) 645-8000

Interoperability endpoints

  • Direct secure messaging: jsmith1361028@direct.sw.org
  • FHIR API: https://api.platform.athenahealth.com/18412/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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 3

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": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1215468897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5904 SUMMERFIELD DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034306",
            "telephone_number": "430-200-4350",
            "fax_number": "855-903-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5904 SUMMERFIELD DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034306",
            "telephone_number": "430-200-4350",
            "fax_number": "855-903-3930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6201 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "75390",
            "country_code": "US",
            "telephone_number": "214-633-5555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2999 Olympus Blvd",
            "address_purpose": "LOCATION",
            "city": "Coppell",
            "state": "TX",
            "postal_code": "750190122",
            "country_code": "US",
            "telephone_number": "469-647-4445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-24",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142542",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP142542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.