Michaela D Smith, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

906388 Issued in MS

Practice address

768 Avery Blvd N
Ridgeland, MS 39157-5219

Phone

(601) 487-6482

NPI assigned

Mar 15, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Quinn WellnessGroup PAC ID 1153760574, 2 clinicians

Quinn Healthcare,PLLCGroup PAC ID 6204802796, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Quinn Healthcare,PLLC

  • Family Medicine Physician
  • Ridgeland, MS
  • NPI 1821103920
  Medicare reassignment Care Compare group NPD
• Quinn Wellness

  • Family Medicine Physician
  • Terry, MS
  • NPI 1396502589
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1407504772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 BELLE OAK DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390428254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "768 AVERY BLVD N",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391575219",
            "telephone_number": "601-487-6482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAELA",
        "middle_name": "D",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-15",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "910936",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamila Smith, LPTA
• Jena Naomi Smith, NP-C
• Keiandrea De'Brionne Smith
• Kenley Smith
• Maggie Nicole Smith, DMD
• Todd Michael Smith, RPT
• Violet Rachelle Smooth-Bracey, LPTA
• Kaitlin Ingram Snyder, DPT
• Solecare Medical Foot Spa, LLC
• Soleo Health Inc.

• Family Nurse Practitioner in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.
• 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.