Benjamin Chad Smith, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP171185 Issued in ME

Practice address

6 Telcom Dr
Bangor, ME 04401-3072

Phone

(207) 947-0147

NPI assigned

Oct 11, 2011

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ME

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Health Affiliates Maine, LLC

  • Community/Behavioral Health Agency
  • Auburn, ME
  • NPI 1932413556
  Medicare reassignment NPD
• Benjamin C. Smith, Pmhnp, LLC PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bangor, ME
  • NPI 1700473220
  NPD Authorized official
• Constance W Jordan Anp Pmhnp PLLC

  • Clinic/Center
  • Cape Elizabeth, ME
  • NPI 1770365272
  NPD

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1386929230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-404-8200",
            "fax_number": "207-947-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TELCOM DR",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013072",
            "telephone_number": "207-947-0147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "86 Davis Rd",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "044012311",
            "country_code": "US",
            "telephone_number": "207-992-2205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BENJAMIN",
        "middle_name": "CHAD",
        "name_prefix": "Mr.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-11",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP171185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "CNP171185",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "E400443631",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Smart Vision, LLC
• Mandi Lynn Smiley, CADC
• Eileen L Smith Porter, R.D.
• Adam David Smith, MD
• Austin Smith
• Brooke Charlotte Smith, LMSW-CC
• C Christopher Smith, M.D.F.A.C.S.
• Chelsie Smith, LADC, CCS
• Dustin Smith
• Elizabeth Ann Smith, PMHNP

• Psychiatric/Mental Health Nurse Practitioner in Bangor, ME
• Providers in Bangor, ME by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.