Charniece Smith

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61154507 Issued in WA

Practice address

307 W Cota St
Shelton, WA 98584-2265

Phone

(360) 205-8004

Fax

(360) 839-2820

NPI assigned

Jan 2, 2020

Last updated

Aug 7, 2024By the provider in NPPES

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in GA, WA2 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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Francis Physician Practices LLCGroup PAC ID 8729381033, 217 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Francis Hospital- Emory Healthcare Hospital, Columbus, GA, CCN 110129

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• St. Francis Physician Practices LLC

  dba St. Francis Primary Care

  • Family Medicine Physician
  • Columbus, GA
  • NPI 1326749417
  Medicare reassignment Care Compare group NPD
• Telecare Mental Health Services of Washington, Inc

  dba Telecare Recovery Partnership

  • Psychiatric Residential Treatment Facility
  • Tacoma, WA
  • NPI 1780913657
  Medicare reassignment NPD
• Personal Recovery Network LLC

  dba LifeStance Health

  • Psychiatry Physician
  • Stockbridge, GA
  • NPI 1881990869
  Medicare reassignment NPD
• Telecare Mental Health Services of Washington Inc

  dba King County PACT

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tukwila, WA
  • NPI 1902540362
  NPD
• Telecare Mental Health Services of Washington, Inc

  dba Telecare Shelton E&T

  • Mental Illness Community Based Residential Treatment Facility
  • Shelton, WA
  • NPI 1275178360
  NPD
• St Francis Physician Practices LLC

  dba St. Francis Psychiatrists

  • Psychiatry Physician
  • Columbus, GA
  • NPI 1124493564
  NPD
• St. Francis Physician Practices LLC

  • Gastroenterology Physician
  • Columbus, GA
  • NPI 1609655646
  NPD

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

• St Francis Health LLC

  dba St Francis Hospital

  • General Acute Care Hospital
  • Columbus, GA
  • NPI 1033228168
  Care Compare affiliation

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1558900993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 MANCHESTER EXPY STE 2001A",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046802",
            "telephone_number": "706-320-3126",
            "fax_number": "706-320-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 W COTA ST",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842265",
            "telephone_number": "360-205-8004",
            "fax_number": "360-839-2820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8071 Upatoi Rdg",
            "address_purpose": "LOCATION",
            "city": "Upatoi",
            "state": "GA",
            "postal_code": "318292161",
            "country_code": "US",
            "telephone_number": "706-289-4876",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "31901",
            "country_code": "US",
            "telephone_number": "706-320-3770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARNIECE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-02",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61154507",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN232587",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "charsmith2009@aol.com",
            "affiliation": "N",
            "address_1": "8071 Upatoi Rdg",
            "city": "Upatoi",
            "state": "GA",
            "country_code": "US",
            "postal_code": "318292161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "chasmith@telecarecorp.com",
            "affiliation": "N",
            "address_1": "307 W Cota St",
            "city": "Shelton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985842265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lindsey Joanne Sheppard, RN
• John A Sheridan, MA, R-AAC
• Skokomish Indian Nation
• Patrick Smart
• Ashley N Smith
• Jacqualyn Smith
• Kristin Lee Smith, LMP
• Michelle R Smith, LMP
• Gwyneth Leeanne Soboleff
• Social Treatment Opportunity Programs II, Inc (STOP Shelton)

• Psychiatric/Mental Health Nurse Practitioner in Shelton, WA
• Providers in Shelton, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.