Individual provider Active NPI

Jenna Elizabeth Smith, DNP, APRN, FNP-C

  • Family Nurse Practitioner
  • Waterville, ME
National Provider Identifier
1477383446
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP241337 Issued in ME
Practice address
295C Kennedy Memorial Dr Ste 1
Waterville, ME 04901-4564
Phone
(207) 873-5437
NPI assigned
Aug 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP241337 ME Primary

Addresses

Primary practice location

295C Kennedy Memorial Dr Ste 1
Waterville, ME 04901-4564

Mailing address

80 Grant Rd
Litchfield, ME 04350-3346
Phone (540) 742-0047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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

Enrollment IDStateProvider typePAC IDDetails
I20241022004029 ME Practitioner - Nurse Practitioner 0143752634 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP241337MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center CurrentSince Aug 26, 2024 Accepting new patients
Mainegeneral Medical Center CurrentSince Aug 26, 2024 Accepting new patients

Locations

295C Kennedy Memorial Dr
Ste 1
Waterville, ME 04901
Phone (207) 873-5437

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Interoperability endpoints

  • Direct secure messaging: jennasmith@mgmcme.allscriptsdirect.net
  • Direct secure messaging: jennasmith@mgh.allscriptsdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1477383446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 GRANT RD",
            "city": "LITCHFIELD",
            "state": "ME",
            "postal_code": "043503346",
            "telephone_number": "540-742-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295C KENNEDY MEMORIAL DR STE 1",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014564",
            "telephone_number": "207-873-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNA",
        "middle_name": "ELIZABETH",
        "credential": "DNP,  APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP241337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, ME

Sources for this page

Verify at the official NPI Registry.