Individual provider Active NPI

Nanette R Smith

  • Certified Registered Nurse Anesthetist
  • Oshkosh, WI
National Provider Identifier
1295788578
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
101701030 Issued in WI
Practice address
500 S Oakwood Rd
Oshkosh, WI 54904-7944
Phone
(920) 223-2000
NPI assigned
May 18, 2006
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
Certified Registered Nurse Anesthetist 367500000X 101701030 WI Primary

Addresses

Primary practice location

500 S Oakwood Rd
Oshkosh, WI 54904-7944

Mailing address

3420 Jackson St
Oshkosh, WI 54901-8144
Phone (920) 426-2211

Other identifiers 1

IdentifierTypeStateIssuer
43380900MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nsmith143850@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050405001384 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315994977 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

210 Wisconsin American Dr
Fond Du Lac, WI 54937-2999
Phone (920) 907-4800

855 N Westhaven Dr
Oshkosh, WI 54904-7668
Phone (920) 303-8700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
46263WIMDOtolaryngology Physician
101701030WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Feb 5, 2015 Accepting new patients
Aurora Medical Group, Inc. Nurse Anesthetist, Certified Registered CurrentSince Feb 5, 2015 Accepting new patients
Anesthesia Services of the Fox Valley SC CurrentSince Jan 2, 2024 Accepting new patients

Locations

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

4648 W Spencer St
Appleton, WI 54914
Phone (920) 731-7557

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

1380 Tullar Rd
Neenah, WI 54956
Phone (920) 205-0379

855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643

414 Doctors Ct
Oshkosh, WI 54901
Phone (920) 303-5020

500 S Oakwood Rd
Oshkosh, WI 54904
Phone (920) 223-0501

Interoperability endpoints

  • Direct secure messaging: nsmith143850@direct.myadvocateaurora.org

Organizations & group practices 3

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 1

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1295788578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 JACKSON ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549018144",
            "telephone_number": "920-426-2211",
            "fax_number": "920-426-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S OAKWOOD RD",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047944",
            "telephone_number": "920-223-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NANETTE",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "101701030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43380900",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nsmith143850@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 S Oakwood Rd",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549047944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "500 S Oakwood Rd",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549047944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.