Individual provider Active NPI

Mary Beth Smith, APRN

  • Women's Health Nurse Practitioner
  • Norfolk, NE
National Provider Identifier
1386630051
Registry record updated Aug 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
111255 Issued in NE
Practice address
302 W Phillip Ave
Norfolk, NE 68701-5248
Phone
(402) 371-8000
Fax
(402) 371-0971
NPI assigned
Sep 27, 2005
Last updated
Aug 13, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2015

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 111255 NE Primary
Ambulatory Women's Health Care Registered Nurse 163WW0101X 53411 NE

Addresses

Primary practice location

302 W Phillip Ave
Norfolk, NE 68701-5248

Mailing address

302 W Phillip Ave
Norfolk, NE 68701-5248
Phone (402) 371-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20121116000531 NE Practitioner - Nurse Practitioner 7719138924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gynecology and Fertility, P.C.Group PAC ID 6608866264, 6 clinicians

Practice addresses (Care Compare)

1500 S 48TH St
Suite 508
Lincoln, NE 68506-1279
Phone (402) 483-2886

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53411NEMDAmbulatory Women's Health Care Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Gynecology & Fertility, P.C. CurrentSince Jun 6, 2024 Accepting new patients

Locations

1500 S 48th St
Ste 508
Lincoln, NE 68506
Phone (402) 483-2886

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1386630051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W PHILLIP AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687015248",
            "telephone_number": "402-371-8000",
            "fax_number": "402-371-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W PHILLIP AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687015248",
            "telephone_number": "402-371-8000",
            "fax_number": "402-371-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARY",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-27",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NE",
            "license": "111255",
            "primary": true
        },
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "NE",
            "license": "53411",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

Verify at the official NPI Registry.