Individual provider Active NPI

Gregory A. Smith, FNP

  • Family Nurse Practitioner
  • Beaumont, TX
National Provider Identifier
1245204890
Registry record updated Sep 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
559394 Issued in TX
Practice address
2955 Harrison St
Suite 301
Beaumont, TX 77702-1154
Phone
(409) 923-1650
Fax
(409) 923-1651
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2014

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 559394 TX Primary

Addresses

Primary practice location

2955 Harrison St
Suite 301
Beaumont, TX 77702-1154

Mailing address

2955 Harrison St
Suite 301
Beaumont, TX 77702-1154
Phone (409) 923-1650

Other identifiers 1

IdentifierTypeStateIssuer
179210302MedicaidTX

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
I20050804000514 TX Practitioner - Nurse Practitioner 2466481007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Smith and Smith, PLLCGroup PAC ID 4385780576, 3 clinicians

Practice addresses (Care Compare)

2955 Harrison St
Suite 301
Beaumont, TX 77702-1157
Phone (409) 236-1650

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
559394TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ahmad Medical PC PastSince Sep 14, 2009 Accepting new patients

Organizations & group practices 2

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 2

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1245204890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 HARRISON ST",
            "address_2": "SUITE 301",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021154",
            "telephone_number": "409-923-1650",
            "fax_number": "409-923-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 HARRISON ST",
            "address_2": "SUITE 301",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021154",
            "telephone_number": "409-923-1650",
            "fax_number": "409-923-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GREGORY",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "559394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179210302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.