Individual provider Active NPI

Erica Jane Smith, NP-C

  • Primary Care Nurse Practitioner
  • Jefferson, GA
National Provider Identifier
1376001446
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN222401 Issued in GA
Practice address
1057 Winder Hwy
Jefferson, GA 30549-6314
Phone
(706) 708-2277
NPI assigned
Mar 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X RN222401 GA Primary

Addresses

Primary practice location

1057 Winder Hwy
Jefferson, GA 30549-6314

Mailing address

787 Hawkins Creek Dr
Jefferson, GA 30549-5418

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230330000893 GA Practitioner - Nurse Practitioner 0143694729 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN222401GAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Flint Health Enhancements, LLC CurrentSince Jan 24, 2023 Accepting new patients
Georgia Kidney Consultants, LLC PastSince Nov 1, 2020 Accepting new patients
Commerce Spinal Center,P.C. PastSince Jan 24, 2023 Accepting new patients

Locations

1057 Winder Hwy
Jefferson, GA 30549
Phone (706) 387-0305

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": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1376001446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "787 HAWKINS CREEK DR",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305495418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 WINDER HWY",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305496314",
            "telephone_number": "706-708-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ERICA",
        "middle_name": "JANE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN222401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, GA

Sources for this page

Verify at the official NPI Registry.