Pamela Denise Smith, NURSE PRACTITIONER

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

11032874 Issued in FL

Practice address

4100 N Wickham Rd Unit 107a-334
Melbourne, FL 32935-2485

Phone

(757) 644-9980

NPI assigned

May 17, 2024

Sex

Female

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 FL

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cardiorenal Therapeutics LLCGroup PAC ID 7416280425, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Cardiorenal Therapeutics LLC

  • Nephrology Physician
  • Jacksonville, FL
  • NPI 1457917304
  Medicare reassignment Care Compare group NPD
• Altea Medical Florida PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Cloud, FL
  • NPI 1083493860
  Medicare reassignment NPD
• Florida Rehab Specialists, PLLC

  • Adult Medicine Physician
  • Williston, FL
  • NPI 1447941984
  Medicare reassignment NPD
• Post Acute Medical PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Lanham, MD
  • NPI 1730713025

  FL

  Medicare reassignment NPD
• Brevard Geriatrics, LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Melbourne, FL
  • NPI 1225682784
  NPD

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

{
    "created_epoch": "1715904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1386493526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 N WICKHAM RD UNIT 107A-334",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352485",
            "telephone_number": "757-644-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 N WICKHAM RD UNIT 107A-334",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352485",
            "telephone_number": "757-644-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PAMELA",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-17",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11032874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry Lee Smith, D.C
• Melanie Smith
• Melissa Jo Smith, APRN
• Michelle Smith, PA-C
• Mikayla Selga Smith
• Pamela Elizabeth Smith, M.A.,CCC-SLP
• Robert Thomas Smith II, PTA
• Rochelle J. Smith, SLP
• Ross H Smith, DMD
• Sarah Smith

• Gerontology Nurse Practitioner in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Gerontology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.