Priscilla Waters Smith

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1221824 Issued in NC

Practice address

1202 N Brightleaf Blvd Ste C
Smithfield, NC 27577-4258

Phone

(919) 912-5006

NPI assigned

Aug 13, 2024

Sex

Female

Sole proprietor

No

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 NC

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

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mainstreet and Kidsstreet of North Carolina PLLCGroup PAC ID 6901290238, 76 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mainstreet and Kidsstreet of North Carolina PLLC

  • Urgent Care Clinic/Center
  • Locust, NC
  • NPI 1144803040
  Medicare reassignment Care Compare group NPD
• Mainstreet and Kidsstreet of North Carolina PLLC

  • Urgent Care Clinic/Center
  • Burlington, NC
  • NPI 1043170558
  NPD
• Mainstreet and Kidsstreet of North Carolina PLLC

  • Urgent Care Clinic/Center
  • Smithfield, NC
  • NPI 1063129799
  NPD
• Mainstreet and Kidsstreet of North Carolina PLLC

  • Rural Health Clinic/Center
  • Smithfield, NC
  • NPI 1578359329
  NPD

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1225869068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 1ST AVE N UNIT 3",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352031866",
            "telephone_number": "205-545-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 N BRIGHTLEAF BLVD STE C",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275774258",
            "telephone_number": "919-912-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PRISCILLA",
        "middle_name": "WATERS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "1221824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Laurence Smith, D.C.
• Erin Marett Smith, DNP-FNP
• Heather Hecei Smith, WHNP
• Laura Elizabeth Smith, PA-C
• Lisa Marie Smith
• Sara Anne Smith, LCSW, MSW
• Scott Alan Smith, MA LPA
• Susan B Smith, RDH
• Treva Laytana Smith, MA, LCAS(P)
• Smithfield Chiropractic PLLC

• Physician Assistant in Smithfield, NC
• Providers in Smithfield, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.