Stephanie I Smith, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

277005238 Issued in IL

Practice address

4 Memorial Dr Ste 210
Alton, IL 62002-6751

Phone

(618) 463-5905

Fax

(618) 463-5935

NPI assigned

Jul 23, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Stephanie I O'Brian Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL, MO2 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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Southern Illinois Healthcare Foundation IncGroup PAC ID 1456256874, 117 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.

• Southern Illinois Healthcare Foundation Inc

  • Federally Qualified Health Center (FQHC)
  • Centreville, IL
  • NPI 1609813500
  Medicare reassignment Care Compare group NPD
• Fairview Heights Medical Group SC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1679503668

  IL

  Medicare reassignment Care Compare group
• Mercy Hospital South

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1568481984
  Medicare reassignment NPD
• Southern Illinois Healthcare Foundation Inc

  • Federally Qualified Health Center (FQHC)
  • O Fallon, IL
  • NPI 1225556996
  NPD
• Southern Illinois Healthcare Foundation Inc

  • Federally Qualified Health Center (FQHC)
  • Waterloo, IL
  • NPI 1821813247
  NPD
• Mercy Hospital South

  • Medicare Defined Swing Bed Hospital Unit
  • Saint Louis, MO
  • NPI 1033714209
  NPD

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1467005009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MEMORIAL DR STE 210",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026704",
            "telephone_number": "618-463-5905",
            "fax_number": "618-463-5935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MEMORIAL DR STE 210",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026751",
            "telephone_number": "618-463-5905",
            "fax_number": "618-463-5935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 N Illinois Ln",
            "address_purpose": "LOCATION",
            "city": "Swansea",
            "state": "IL",
            "postal_code": "622261969",
            "country_code": "US",
            "telephone_number": "618-257-6380",
            "fax_number": "618-257-6444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 N Illinois Ln",
            "address_purpose": "LOCATION",
            "city": "Swansea",
            "state": "IL",
            "postal_code": "622261969",
            "country_code": "US",
            "telephone_number": "618-257-6380",
            "fax_number": "618-257-6444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHANIE",
        "middle_name": "I",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209019631",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "277005238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4000 N Illinois Ln",
            "city": "Swansea",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622261969",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephanie.obrian.1@9559.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "4 Memorial Dr Ste 210",
            "city": "Alton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620026751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "O'BRIAN",
            "middle_name": "I",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katlyn Ann Smith, PA-C
• Kristy Smith
• Natalie J Smith, M. ED., LPC, NCC
• Rebecca Smith
• Shamika N Smith, MS
• Andrea Snipes
• Rebecca Snow-Grimm
• Colin Michael Solomon, APN
• Thomas Dean Sotiropoulos, D.D.S.
• Southeastern Emergency Physicians of Memphis LLC

• Nurse Practitioner in Alton, IL
• Providers in Alton, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; 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.