Marla Rae Smith

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

209007742 Issued in IL

Practice address

869 North Illinois RT 3
Waterloo, IL 62298

Phone

(618) 939-7771

Fax

(618) 939-7746

NPI assigned

Dec 20, 2007

Sex

Female

Sole proprietor

Yes

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

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heartland Women's Healthcare LTDGroup PAC ID 1759270648, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Red Bud Regional Hospital Hospital, Red Bud, IL, CCN 141348
• HSHS St Elizabeth's Hospital Hospital, O Fallon, IL, CCN 140187

Merit-based Incentive Payment System (MIPS)

Final score

82.36 of 100Reported as group

Quality

84.63

Improvement activities

40

Cost

55.93

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marla.smith.1@21608.direct.athenahealth.com

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.

• Heartland Women's Healthcare LTD

  • Obstetrics & Gynecology Physician
  • Marion, IL
  • NPI 1851307532
  Medicare reassignment Care Compare group NPD
• Heartland Women's Healthcare Mo PC

  • Obstetrics & Gynecology Physician
  • Wentzville, MO
  • NPI 1588191431
  Medicare reassignment NPD
• Waterloo Women's Health

  • Women's Health Nurse Practitioner
  • Waterloo, IL
  • NPI 1841523776
  NPD (past) Authorized official
• Heartland Women's Healthcare LTD

  • Clinical Medical Laboratory
  • Swansea, IL
  • NPI 1043852932
  NPD
• Heartland Women's Healthcare Mo PC

  • Rural Health Clinic/Center
  • Poplar Bluff, MO
  • NPI 1356849616
  NPD
• Heartland Women's Healthcare Il PC

  • Obstetrics & Gynecology Physician
  • Shiloh, IL
  • NPI 1568057131
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Deaconess Illinois Red Bud Regional Hospital Inc

  dba Red Bud Regional Hospital

  • Critical Access Hospital
  • Red Bud, IL
  • NPI 1407573132
  Care Compare affiliation
• St Elizabeths Hospital of the Hospital Sisters of the Third Order

  dba HSHS St. Elizabeth's Hospital

  • General Acute Care Hospital
  • O'Fallon, IL
  • NPI 1629057302
  Care Compare affiliation

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252454400000",
    "number": "1548444011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 COVINGTON DRIVE",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622983296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "869 NORTH ILLINOIS RT 3",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "62298",
            "telephone_number": "618-939-7771",
            "fax_number": "618-939-7746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARLA",
        "middle_name": "RAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-20",
        "last_updated": "2009-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MO",
            "license": "152008",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209007742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Shorey, RSA
• Stephanie Skelly, MD
• Jamie Smith, RSA
• Kelsie Lynnn Smith, MHP
• Lesley Smith, RSA
• Maryem Smith
• Laura E Sorbel Beabout, DMD
• Southern Illinois Center for Health
• Southern Illinois Healthcare Foundation Inc (SIHF Healthcare)
• Southern Illinois Imaging Associates, LLC

• Women's Health Nurse Practitioner in Waterloo, IL
• Providers in Waterloo, IL by specialty
• Women's Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; 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.