Thomas J Smith, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

2019045891 Issued in MO

Practice address

803 Rena St
Kirksville, MO 63501-2012

Phone

(660) 342-5295

NPI assigned

Jul 28, 2020

Sex

Male

Sole proprietor

Yes

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 MO

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McPherson Medical and Diagnostic LLCGroup PAC ID 5698773539, 88 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hannibal Regional Hospital Hospital, Hannibal, MO, CCN 260025
• Pershing Memorial Hospital Hospital, Brookfield, MO, CCN 261307
• Moberly Regional Medical Center Hospital, Moberly, MO, CCN 260074
• Sullivan County Memorial Hospital Hospital, Milan, MO, CCN 261306

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.

• McPherson Medical & Diagnostic, LLC

  dba Malden Family Clinic and Diagnostic

  • Clinic/Center
  • Malden, MO
  • NPI 1003407883
  Medicare reassignment Care Compare group NPD
• McPherson Medical & Diagnostic, LLC

  • Family Medicine Physician
  • Kennett, MO
  • NPI 1124679774
  NPD
• McPherson Medical & Diagnostic, LLC

  • Family Medicine Physician
  • Gideon, MO
  • NPI 1497189864
  NPD
• McPherson Medical & Diagnostic, LLC

  • Family Medicine Physician
  • Steele, MO
  • NPI 1164440806
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• General John J Pershing Memorial Hospital Association

  dba Pershing Memorial Hospital

  • Critical Access Hospital
  • Brookfield, MO
  • NPI 1417991159
  Care Compare affiliation
• Hannibal Regional Healthcare System, Inc

  • Rural Acute Care Hospital
  • Hannibal, MO
  • NPI 1922042704
  Care Compare affiliation
• Moberly Hospital Company LLC

  dba Moberly Regional Medical Center

  • General Acute Care Hospital
  • Moberly, MO
  • NPI 1770554305
  Care Compare affiliation
• Sullivan County Memorial Hospital

  • Critical Access Hospital
  • Milan, MO
  • NPI 1114067832
  Care Compare affiliation

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1417566142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 RENA ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635012012",
            "telephone_number": "660-342-5295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 RENA ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635012012",
            "telephone_number": "660-342-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "ACNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2019045891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI STATE BOARD OF NURSING NURSE PRACTITIONER LICENSE",
            "identifier": "2019045891",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelli Renae Slaughter, FNP
• Sloan Eyecare Center L.L.C (Premier Eyecare Associates)
• Crescent Smith, RN
• Maria Smith
• Miranda Marie Smith
• Tizita Smith
• Walker Curtis Smith, PHARM.D.
• Brittney Frances Snelling, ATC, PTA
• Christine Snelling, LCSW
• Eric J Snider, D.O.

• Acute Care Nurse Practitioner in Kirksville, MO
• Providers in Kirksville, MO by specialty
• Acute Care Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.