Mary Lou S Smith, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9431231 Issued in FL

Practice address

1840 Eldron Blvd SE Ste 1
Palm Bay, FL 32909-6871

Phone

(321) 312-4580

Fax

(321) 914-4053

NPI assigned

Mar 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• SSM Health Care St. Louis

  • Cardiovascular Disease Physician
  • Bridgeton, MO
  • NPI 1376598599
  NPD (past)
• SSM Health Care St. Louis

  • Emergency Medicine Physician
  • Saint Charles, MO
  • NPI 1427002922
  NPD (past)
• SSM St. Charles Clinic Medical Group, Inc.

  • Family Medicine Physician
  • Saint Charles, MO
  • NPI 1811932973
  NPD (past)

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1467413237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 YACHT HAVEN DR",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329312627",
            "telephone_number": "636-346-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 ELDRON BLVD SE STE 1",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329096871",
            "telephone_number": "321-312-4580",
            "fax_number": "321-914-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARY LOU",
        "middle_name": "S",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "ARNP9431231",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9431231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delia A. Smith, M.D.
• Erin Eileen Smith, MA-CCC-SLP
• Heidi Smith
• Judy Ann Smith
• Kyle Austin Smith
• Rebecca N Smith
• Sabrina Lynn Smith, RN
• Tatiana Smith, RBT
• Kasey Elizabeth Snow, PA-C
• Socially Significant Applied Behavior Analysis

• Family Nurse Practitioner in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.