Tamara Jenean Smith, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R587702 Issued in MS

Practice address

602 Brunson Dr
Tupelo, MS 38801-4947

Phone

(662) 680-3855

Fax

(662) 680-3372

NPI assigned

Aug 31, 2006

Sex

Female

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 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Ms State Department of Health

  • Community/Behavioral Health Agency
  • Jackson, MS
  • NPI 1053489260

  MS

  Medicare reassignment
• Mississippi State Department of Health

  • Clinical Medical Laboratory
  • Jackson, MS
  • NPI 1255479630
  NPD
• Gynecologic and Obstetric Services, PA

  • Family Nurse Practitioner
  • Tupelo, MS
  • NPI 1912019092

  Family

  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407968530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 BRUNSON DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014947",
            "telephone_number": "662-680-3855",
            "fax_number": "662-680-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 BRUNSON DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014947",
            "telephone_number": "662-680-3855",
            "fax_number": "662-680-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TAMARA",
        "middle_name": "JENEAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R587702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00113839",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Niki Smith
• Robert Brasfield Smith, M.D.
• Robert James Smith, LCSW
• Sandra Smith
• Stephanie Elyse Smith, MSN, FNP-C
• Teresa Ann Smith
• Twila Smith, FNP
• Valeda Smith
• Jacob Allen Smithey, MD
• Shanta Sneed, LCSW

• All providers in Tupelo, MS
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.