Individual provider Active NPI

Ryan Chanler Smith, NP

  • Family Nurse Practitioner
  • Canton, MS
National Provider Identifier
1386535557
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
907560 Issued in MS
Practice address
1621 W Peace St
Canton, MS 39046-9041
Phone
(601) 391-2716
NPI assigned
Jul 14, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 907560 MS Primary

Addresses

Primary practice location

1621 W Peace St
Canton, MS 39046-9041

Mailing address

1621 W Peace St
Canton, MS 39046-9041
Phone (601) 391-2716

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20251209003226 MS Practitioner - Nurse Practitioner 6204320179 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians

Practice addresses (Care Compare)

1621 W Peace St
Canton, MS 39046-9041
Phone (931) 253-1110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
907560MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Sep 25, 2025 Accepting new patients
Fast Pace Mississippi, PLLC Family CurrentSince Dec 1, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 25, 2025 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince Dec 1, 2025 Accepting new patients

Locations

1621 W Peace St
Canton, MS 39046
Phone (601) 391-2716

7 Professional Pkwy
Ste 101
Hattiesburg, MS 39402
Phone (601) 781-1661

50 Veterans Memorial Dr
Kosciusko, MS 39090
Phone (662) 633-4216

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

Organizations & group practices 6

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": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1386535557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 W PEACE ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390469041",
            "telephone_number": "601-391-2716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 W PEACE ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390469041",
            "telephone_number": "601-391-2716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RYAN",
        "middle_name": "CHANLER",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "907560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MS

Sources for this page

Verify at the official NPI Registry.