Erin Theresa Smith

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN11033223 Issued in FL

Practice address

10752 Deerwood Park Blvd Ste 100
Jacksonville, FL 32256-4846

Phone

(904) 800-4775

NPI assigned

May 11, 2022

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

Other names 1

• Erin Theresa Mogavero Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717804800000",
    "number": "1235875311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10752 DEERWOOD PARK BLVD STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322564846",
            "telephone_number": "904-800-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10752 DEERWOOD PARK BLVD STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322564846",
            "telephone_number": "904-800-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ERIN",
        "middle_name": "THERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-11",
        "last_updated": "2024-06-08",
        "certification_date": "2024-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11033223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "MOGAVERO",
            "middle_name": "THERESA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Doris Elizabeth Smith, ARNP
• Duncan Kenneth Smith, O.D.
• Edward W.P. Smith, MD
• Emily Nicole Smith
• Erica Self Smith, APRN
• Frances Smith, PT
• Fredrica Monea Smith, LMT
• Genesis Smith
• George Smith, MSW
• Gloreatha Smith, MBA

• Psychiatric/Mental Health Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.