NPIMap

Individual provider Active NPI

Cassi Marie Smith, APRN

  • Family Nurse Practitioner
  • Fairfax, OK
National Provider Identifier
1215522917
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
200908 Issued in OK
Practice address
40 Hospital Rd
Fairfax, OK 74637-5084
Phone
(918) 642-8827
Fax
(918) 642-3298
NPI assigned
Mar 4, 2021
Last updated
Nov 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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 200908 OK Primary

Addresses

Primary practice location

40 Hospital Rd
Fairfax, OK 74637-5084

Mailing address

40 Hospital Rd
Fairfax, OK 74637-5084
Phone (918) 642-8827

Other practice location 1

5705 E 71st St Ste 150C
Tulsa, OK 74136-6651
Phone (918) 477-9080

Other practice location 2

1900 N 14th St
Ponca City, OK 74601-2035
Phone (580) 765-3321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210812003787 OK Practitioner - Nurse Practitioner 1456754688 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Wellness Fairfax IncGroup PAC ID 3678904752, 10 clinicians
Cah Acquisition Company 12 LLCGroup PAC ID 8820123052, 5 clinicians

Practice addresses (Care Compare)

40 Hospital Rd
Fairfax, OK 74637-5084
Phone (918) 642-3291

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Wellness Anadarko Inc CurrentSince Jun 8, 2024 Accepting new patients
Rural Wellness Fairfax Inc CurrentSince Jul 1, 2021 Accepting new patients
Nes Oklahoma, Inc. CurrentSince Jun 30, 2021 Accepting new patients
Rural Wellness Anadarko Inc CurrentSince Jun 8, 2024 Accepting new patients
Rural Wellness Fairfax Inc CurrentSince Jul 1, 2021 Accepting new patients

Locations

1002 E Central Blvd
Anadarko, OK 73005
Phone (405) 247-2551

40 Hospital Rd
Fairfax, OK 74637
Phone (918) 642-8827

Dept 960617
Oklahoma City, OK 73196

1900 N 14th St
Ponca City, OK 74601
Phone (580) 718-2932

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1215522917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 HOSPITAL RD",
            "city": "FAIRFAX",
            "state": "OK",
            "postal_code": "746375084",
            "telephone_number": "918-642-8827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 HOSPITAL RD",
            "city": "FAIRFAX",
            "state": "OK",
            "postal_code": "746375084",
            "telephone_number": "918-642-8827",
            "fax_number": "918-642-3298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5705 E 71st St Ste 150C",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741366651",
            "country_code": "US",
            "telephone_number": "918-477-9080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1900 N 14th St",
            "address_purpose": "LOCATION",
            "city": "Ponca City",
            "state": "OK",
            "postal_code": "746012035",
            "country_code": "US",
            "telephone_number": "580-765-3321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CASSI",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "200908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, OK

Sources for this page

Verify at the official NPI Registry.