Individual provider Active NPI

Shaniece Smith, NP

  • Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1558832956
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71009045A Issued in IN
Practice address
8301 Harcourt Rd Ste 200
Indianapolis, IN 46260-2082
Phone
(317) 415-6600
Fax
(317) 415-6649
NPI assigned
Dec 10, 2018
Last updated
Sep 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71009045A IN Primary
Family Nurse Practitioner 363LF0000X F09181038 IN

Addresses

Primary practice location

8301 Harcourt Rd Ste 200
Indianapolis, IN 46260-2082

Mailing address

PO Box 749495
Atlanta, GA 30374-9495
Phone (855) 963-2100

Other practice location 1

500 W Cummings Park Ste 2950
Woburn, MA 01801-6536
Phone (781) 376-6938

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F09181038INMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Oncology Partners, P.a. Past Accepting new patients
Major Hospital Past Accepting new patients
Focus Care Solutions Inc. Past Accepting new patients

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, 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": "1544400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1558832956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749495",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749495",
            "telephone_number": "855-963-2100",
            "fax_number": "239-236-2775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 HARCOURT RD STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602082",
            "telephone_number": "317-415-6600",
            "fax_number": "317-415-6649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Cummings Park Ste 2950",
            "address_purpose": "LOCATION",
            "city": "Woburn",
            "state": "MA",
            "postal_code": "018016536",
            "country_code": "US",
            "telephone_number": "781-376-6938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHANIECE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-10",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71009045A",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "F09181038",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.