Individual provider Active NPI

Charles Allen Smith, CRNP

  • Acute Care Nurse Practitioner
  • Cullman, AL
National Provider Identifier
1538363239
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-060971 Issued in AL
Practice address
1750 Al Highway 157
Cullman, AL 35058-3622
Phone
(256) 255-2500
Fax
(256) 255-2501
NPI assigned
Jun 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-060971 AL Primary

Addresses

Primary practice location

1750 Al Highway 157
Cullman, AL 35058-3622

Mailing address

1750 Al Highway 157
Cullman, AL 35058
Phone (256) 255-2500

Other practice location 1

1912 Al Highway 157
Cullman, AL 35058-0609
Phone (256) 737-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20080104000435 AL Practitioner - Nurse Practitioner 1557441474 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cullman Regional Medical Group Hospitalists LLCGroup PAC ID 5395176481, 34 clinicians

Practice addresses (Care Compare)

1912 Al Hwy 157
Cullman, AL 35058-0609
Phone (256) 737-2682

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cullman Oncology, P.C. CurrentSince Aug 11, 2017 Accepting new patients
Ultra Health LLC CurrentSince May 28, 2025 Accepting new patients
Cullman Regional Medical Group Hospitalists LLC CurrentSince Jul 1, 2021 Accepting new patients

Locations

1750 AL Highway 157
Cullman, AL 35058
Phone (256) 255-2500

1912 AL Highway 157
Cullman, AL 35058
Phone (256) 737-2496

1130 Hale St
Oxford, AL 36203
Phone (256) 831-0481

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14578/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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 1

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1538363239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 AL HIGHWAY 157",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "35058",
            "telephone_number": "256-255-2500",
            "fax_number": "256-255-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 AL HIGHWAY 157",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350583622",
            "telephone_number": "256-255-2500",
            "fax_number": "256-255-2501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1912 Al Highway 157",
            "address_purpose": "LOCATION",
            "city": "Cullman",
            "state": "AL",
            "postal_code": "350580609",
            "country_code": "US",
            "telephone_number": "256-737-2000",
            "fax_number": "256-737-2152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARLES",
        "middle_name": "ALLEN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-060971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

Verify at the official NPI Registry.