Individual provider Active NPI

Destiny Brooke Johnson Smith, CNM

  • Midwife
  • Chattanooga, TN
National Provider Identifier
1306506837
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
Practice address
1651 Gunbarrel Rd Ste 101a
Chattanooga, TN 37421-3289
Phone
(423) 899-9133
NPI assigned
Dec 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X Primary

Addresses

Primary practice location

1651 Gunbarrel Rd Ste 101a
Chattanooga, TN 37421-3289

Mailing address

2550 Business Park Dr NE
Cleveland, TN 37311-6503

Other practice location 1

2550 Business Park Dr NE
Cleveland, TN 37311-6503
Phone (423) 339-8881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220728001021 TN Practitioner - Certified Nurse Midwife (CNM) 8628450384 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifecircle Womens Health Care PC CurrentSince Aug 1, 2022 Accepting new patients
Lifecircle Womens Health Care PC CurrentSince Aug 1, 2022 Accepting new patients
Galen Medical Group, PC CurrentSince May 1, 2024 Accepting new patients

Locations

1651 Gunbarrel Rd
Ste 201
Chattanooga, TN 37421
Phone (423) 899-9133

1651 Gunbarrel Rd
Ste 302
Chattanooga, TN 37421
Phone (423) 899-2904

1651 Gunbarrel Rd
Ste 101A
Chattanooga, TN 37421
Phone (423) 899-9133

2301 N Ocoee St
Ste A
Cleveland, TN 37311
Phone (423) 322-6399

4976 Alpha Ln
Hixson, TN 37343
Phone (423) 308-0280

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/serenitybhs/r4/
  • Direct secure messaging: desmith1@99fdbf75.micromddirect.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1640304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1306506837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 BUSINESS PARK DR NE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373116503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 GUNBARREL RD STE 101A",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213289",
            "telephone_number": "423-899-9133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 Business Park Dr NE",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "TN",
            "postal_code": "373116503",
            "country_code": "US",
            "telephone_number": "423-339-8881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DESTINY",
        "middle_name": "BROOKE JOHNSON",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-24",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.