Individual provider Active NPI

Heather Marie Smith

  • Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1457078214
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71013211A Issued in IN
Practice address
4506 N 1St Ave
Evansville, IN 47710-3624
Phone
(812) 428-6161
NPI assigned
Oct 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3018517 KY
Family Nurse Practitioner 363LF0000X 71013211A IN
Nurse Practitioner 363L00000X 71013211A IN Primary

Addresses

Primary practice location

4506 N 1St Ave
Evansville, IN 47710-3624

Mailing address

4506 N 1St Ave
Evansville, IN 47710-3624
Phone (812) 428-6161

Other practice location 1

2242 US Highway 41 N
Henderson, KY 42420-2375
Phone (270) 844-8515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221115000379 IN Practitioner - Nurse Practitioner 5597133017 Reassigns benefits to 1 organization
I20221121002067 KY Practitioner - Nurse Practitioner 5597133017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Clinic IncGroup PAC ID 3375610116, shared by 10 NPIs, 411 clinicians

Practice addresses (Care Compare)

2242 US Hwy 41 N
Henderson, KY 42420-2375
Phone (270) 844-8515

545 S Boehne Camp Rd
Evansville, IN 47712-3703
Phone (812) 429-1818

Hospital & facility affiliations

  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71013211AINMDNurse Practitioner
3018517KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic, Inc Nurse Practitioner CurrentSince Oct 26, 2022 Accepting new patients
Deaconess Clinic Inc Nurse Practitioner CurrentSince Oct 26, 2022 Accepting new patients
Deaconess Clinic, Inc. Nurse Practitioner CurrentSince Oct 26, 2022 Accepting new patients
Deaconess Clinic Inc. Nurse Practitioner Current Accepting new patients
Deaconess Clinic, Inc Nurse Practitioner Current Accepting new patients
Deaconess Clinic, Inc Nurse Practitioner Past Accepting new patients

Locations

3150 Warrick Dr
Boonville, IN 47601
Phone (812) 450-6430

2622 Menards Dr
Evansville, IN 47715
Phone (812) 450-2622

120 SE 4th St
Evansville, IN 47708
Phone (812) 426-6638

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

545 S Boehne Camp Rd
Evansville, IN 47712
Phone (812) 402-1264

4506 N 1st Ave
Evansville, IN 47710
Phone (812) 428-6161

4011 Gateway Blvd
Ste 100
Newburgh, IN 47630
Phone (812) 858-2100

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

1414 W Broadway St
Princeton, IN 47670
Phone (812) 385-5283

2242 US Highway 41 N
Henderson, KY 42420
Phone (270) 844-8515

1700 US Highway 60 W
Morganfield, KY 42437
Phone (270) 389-0031

2710 Heartland Crossing Blvd
Owensboro, KY 42303
Phone (270) 561-0140

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1457078214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4506 N 1ST AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477103624",
            "telephone_number": "812-428-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4506 N 1ST AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477103624",
            "telephone_number": "812-428-6161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2242 US Highway 41 N",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "KY",
            "postal_code": "424202375",
            "country_code": "US",
            "telephone_number": "270-844-8515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2023-03-01",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3018517",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71013211A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71013211A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.