Individual provider Active NPI

Regina Christy Smith, APN

  • Women's Health Nurse Practitioner
  • Southaven, MS
National Provider Identifier
1366596066
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
908491 Issued in MS
Practice address
3964 Goodman Rd E Ste 131
Southaven, MS 38672-8762
Phone
(662) 856-8440
Fax
(662) 350-7032
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 908491 MS Primary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 11744 TN

Addresses

Primary practice location

3964 Goodman Rd E Ste 131
Southaven, MS 38672-8762

Mailing address

3964 Goodman Rd E Ste 131
Southaven, MS 38672-8762
Phone (662) 856-8440

Other identifiers 2

IdentifierTypeStateIssuer
1525669MedicaidTN
03989793MedicaidMS

Other names 1

  • Regina Christine Dodd Former name

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110928000205 TN Practitioner - Nurse Practitioner 1153592936 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11744TNMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-South Maternal Fetal Medicine PC CurrentSince Sep 1, 2011 Accepting new patients
Southwind Endoscopy Center Past Accepting new patients
Ivyraine Women'S Clinic Women'S Health PastSince Oct 1, 2021 Accepting new patients

Locations

6266 Poplar Ave
Memphis, TN 38119
Phone (901) 682-2595

Interoperability endpoints

  • Direct secure messaging: rsmith@mmfm.directglo.com
  • Direct secure messaging: rsmith32084@mlh.direct-ci.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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1366596066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3964 GOODMAN RD E STE 131",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386728762",
            "telephone_number": "662-856-8440",
            "fax_number": "662-350-7032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3964 GOODMAN RD E STE 131",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386728762",
            "telephone_number": "662-856-8440",
            "fax_number": "662-350-7032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "REGINA",
        "middle_name": "CHRISTY",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MS",
            "license": "908491",
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "TN",
            "license": "11744",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1525669",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03989793",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REGINA",
            "last_name": "DODD",
            "middle_name": "CHRISTINE",
            "credential": "APN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.