Patrick Ian Smith, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

ARNP9397680 Issued in FL

Practice address

3333 W 20TH St
Jacksonville, FL 32254-1703

Phone

(904) 695-9145

Fax

(904) 695-2465

NPI assigned

Oct 30, 2018

Sex

Male

Sole proprietor

Yes

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 OR, NV, AZ3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mohave Mental Health Clinic IncGroup PAC ID 7618963935, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

• Mohave Mental Health Clinic Inc

  • Clinic/Center
  • Kingman, AZ
  • NPI 1902894272
  Medicare reassignment Care Compare group NPD
• DHS/Office of Financial Services Irs/Eopc/BMRC/Eotc/Osh/Osh-P

  dba Oregon State Hospital (Salem)

  • Psychiatric Hospital
  • Salem, OR
  • NPI 1508802489
  Medicare reassignment NPD
• Oasis Counseling LLC

  • Mental Health Counselor
  • Henderson, NV
  • NPI 1336400951
  Medicare reassignment NPD
• Innovative Psychiatry LLC

  • Psychiatry Physician
  • Henderson, NV
  • NPI 1427662907
  NPD
• Mohave Mental Health Clinic Inc

  • Clinic/Center
  • Lake Havasu City, AZ
  • NPI 1316023864
  NPD
• Mohave Mental Health Clinic Inc

  • Community/Behavioral Health Agency
  • Kingman, AZ
  • NPI 1922275692
  NPD
• Mental Health Center of Jacksonville, Inc.

  • Community Health Clinic/Center
  • Jacksonville, FL
  • NPI 1366558132
  NPD (past)
• Mohave Mental Health Clinic Inc

  • Psychiatric Hospital Unit
  • Kingman, AZ
  • NPI 1952471518
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kingman Healthcare, Inc

  dba Kingman Regional Medical Center

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917
  Care Compare affiliation

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1356818223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19249",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322459249",
            "telephone_number": "904-743-1883",
            "fax_number": "904-743-5309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 W 20TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322541703",
            "telephone_number": "904-695-9145",
            "fax_number": "904-695-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PATRICK",
        "middle_name": "IAN",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP9397680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Elizabeth Smith
• Nina Agnes Smith, ARNP
• Nina Perez Smith, OT
• Pamela Gayle Smith, MA, LMHC, NCC
• Patricia Louise Smith, RN
• Patrina Smith
• Paula Kim Smith, CWHNP
• Phillis D Smith
• Reuben Louis Smith, MD
• Robert Smith, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; 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.