Smithtown Family Wellness NP PC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

SMITHTOWN FAMILY WELLNESS NP PC

Practice address

300 E Main St Ste 2
Smithtown, NY 11787-2900

Phone

(904) 654-2410

NPI assigned

Feb 10, 2020

Organization subpart

No

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

Authorized official

Name

Smith Doreen, NP

Title

President

Phone

(631) 523-7826

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1215569041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 NICOLLS RD",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117291806",
            "telephone_number": "631-523-7826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E MAIN ST STE 2",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872900",
            "telephone_number": "904-654-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITHTOWN FAMILY WELLNESS NP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-10",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A",
        "authorized_official_last_name": "DOREEN",
        "authorized_official_first_name": "SMITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-523-7826",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://login.practicesuite.com/PracticeSuite/login.do",
            "affiliation": "N",
            "endpointDescription": "Practicesuite Patient portal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "37600 Central Ct Ste 260",
            "city": "Newark",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945603440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Nurse Practitioner in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.