Chase Allen Smith, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

905852 Issued in MS

Practice address

11150 Highway 49
Gulfport, MS 39503-4110

Phone

(228) 831-1700

NPI assigned

Mar 23, 2023

Last updated

Mar 23, 2023By the provider in NPPES

Sex

Male

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 MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• TBD Acquisition II LLC

  dba Gulfport Behavioral Health System

  • Psychiatric Hospital
  • Gulfport, MS
  • NPI 1750891792
  Medicare reassignment NPD
• TBD Acquisition II, LLC

  dba Gulfport Behavioral Health System

  • Clinical Social Worker
  • Gulfport, MS
  • NPI 1003324419
  NPD

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1346943958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11150 HIGHWAY 49",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395034110",
            "telephone_number": "228-831-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11150 HIGHWAY 49",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395034110",
            "telephone_number": "228-831-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHASE",
        "middle_name": "ALLEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "905852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Calvin Smith
• Carlyle Grace Smith, PHARMD
• Carol Ann Smith, M.D.
• Carolyn Dianne Smith
• Chandra Smith
• Claudia Bridgett Smith, RN
• Crystal Ann Smith
• Daniel Bruce Smith, M.D., PHD
• Elena C Smith
• Emily A Smith, P-LPC

• Psychiatric/Mental Health Nurse Practitioner in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.