Mary Katherine Smith, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN250856 Issued in GA

Practice address

409 W 10TH St NE
Rome, GA 30165-2640

Phone

(706) 406-5093

NPI assigned

Sep 29, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mindset for ProsperityGroup PAC ID 3476910845, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Mindset for Prosperity LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Rome, GA
  • NPI 1902545981

  Family

  Medicare reassignment Care Compare group NPD
• Georgia Foot & Ankle Specialists

  • Podiatric Clinic/Center
  • Rome, GA
  • NPI 1801939293
  NPD

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

{
    "created_epoch": "1664409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1356065718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 W 10TH ST NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652640",
            "telephone_number": "706-406-5093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W 10TH ST NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652640",
            "telephone_number": "706-406-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-29",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN250856",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN250856",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Brian Smith, DMD
• Jason L Smith, M D
• Julia Diane Smith
• Justin Smith, M.D.
• Kenneth Leroy Smith Sr., LPC014651
• Misty Gail Smith, NP-C
• Stuart Smith, M.D.
• Susan Smith, RN
• Taylor Ryan Smith, M.D.
• Timothy Smith, PH.D.

• Family Nurse Practitioner in Rome, GA
• Providers in Rome, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.
• 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.