Rebecca Anne Smith, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN175958 Issued in GA

Practice address

245 Country Club Dr BLDG 200a
Stockbridge, GA 30281-7212

Phone

(770) 389-4543

NPI assigned

Aug 10, 2021

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

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.

• Covenant Care Pediatrics PC

  • Pediatrics Physician
  • Stockbridge, GA
  • NPI 1902941503
  NPD (past)

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1366117657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 COUNTRY CLUB DR BLDG 200A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817212",
            "telephone_number": "770-389-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 COUNTRY CLUB DR BLDG 200A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817212",
            "telephone_number": "770-389-4543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1116 Hargrove Ct",
            "address_purpose": "LOCATION",
            "city": "Locust Grove",
            "state": "GA",
            "postal_code": "302483434",
            "country_code": "US",
            "telephone_number": "404-993-8468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "REBECCA",
        "middle_name": "ANNE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-10",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN175958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Victoria Smith, NP-C
• Kyra Smith
• Nicole L Smith, NP
• Paul Andrew Smith, DMD
• Peter E Smith, D.P.M.
• Sonja Renee Smith, LPN
• Taschovia Smith, LPC, MAC, CCDP-D
• Tiara Smith
• Aderinsola Jesuloluwa Sodiya, OTR/L
• Yoojin Sohn

• Pediatric Nurse Practitioner in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.