Individual provider Active NPI

Vicki Risko Smith, APRN

  • Family Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1528272929
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9356774 Issued in FL
Practice address
1223 Gateway Dr Ste 1a
Melbourne, FL 32901-2607
Phone
(321) 434-6712
Fax
(321) 409-6812
NPI assigned
May 9, 2007
Last updated
Mar 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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 ARNP9356774 FL Primary

Addresses

Primary practice location

1223 Gateway Dr Ste 1a
Melbourne, FL 32901-2607

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306

Other identifiers 2

IdentifierTypeStateIssuer
HF994WOtherFLMEDICARE
010373100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20130613000137 FL Practitioner - Nurse Practitioner 3971632035 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Health First Medical Group, LLC CurrentSince Jan 1, 2015 Accepting new patients
Md2U Florida LLC CurrentSince Jul 22, 2013 Accepting new patients
Health First Medical Group, LLC CurrentSince Jan 1, 2015 Accepting new patients
Oahu Home Care LLC PastSince Mar 22, 2020 Accepting new patients
Kentucky Pain Physicians Past Accepting new patients

Locations

699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272

10151 Deerwood Park Blvd
Ste 200-250
Jacksonville, FL 32256
Phone (904) 704-2527

1223 Gateway Dr
Melbourne, FL 32901
Phone (321) 549-0677

1223 Gateway Dr
Ste 1A
Melbourne, FL 32901
Phone (321) 434-6712

1223 Gateway Dr
Ste 2G
Melbourne, FL 32901

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

Interoperability endpoints

  • Direct secure messaging: vsmith29500@epicdirect.hf.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1528272929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 GATEWAY DR STE 1A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012607",
            "telephone_number": "321-434-6712",
            "fax_number": "321-409-6812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "VICKI",
        "middle_name": "RISKO",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9356774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "HF994W",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010373100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.