Individual provider Active NPI

Amberly Dawn Smith, CRNP

  • Family Nurse Practitioner
  • Florence, AL
National Provider Identifier
1568014751
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-143305 Issued in AL
Practice address
153 Ana Dr
Florence, AL 35630-1731
Phone
(256) 367-0920
Fax
(256) 648-5842
NPI assigned
Jul 9, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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 1-143305 AL Primary

Addresses

Primary practice location

153 Ana Dr
Florence, AL 35630-1731

Mailing address

153 Ana Dr
Florence, AL 35630-1731
Phone (256) 236-7509

Other practice location 1

2129 Helton Dr
Florence, AL 35630-1069
Phone (256) 367-4916

Other practice location 2

234 Keller Park Blvd
Tuscumbia, AL 35674-1417
Phone (256) 381-6963

Other identifiers 1

IdentifierTypeStateIssuer
238552MedicaidAL

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
I20200302001657 AL Practitioner - Nurse Practitioner 0547697617 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimal Healthcare LLCGroup PAC ID 6901268887, 3 clinicians

Practice addresses (Care Compare)

153 Ana Dr
Florence, AL 35630-1731
Phone (256) 367-0920

Hospital & facility affiliations

  • North Alabama Medical Center Hospital, Florence, AL, CCN 010006
  • Helen Keller Hospital Hospital, Sheffield, AL, CCN 010019
  • North Alabama Shoals Hospital Hospital, Muscle Shoals, AL, CCN 010157

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Healthcare LLC CurrentSince May 11, 2023 Accepting new patients
Ecm Health Group LLC CurrentSince Dec 23, 2019 Accepting new patients
Tennessee Valley Pediatric Associatesinc. Pediatrics Past Accepting new patients

Locations

541 W College St
Ste 3200
Florence, AL 35630
Phone (256) 760-0098

541 W College St
Ste 3300
Florence, AL 35630
Phone (256) 766-6026

153 Ana Dr
Florence, AL 35630
Phone (256) 367-0920

2129 Helton Dr
Florence, AL 35630
Phone (256) 718-3200

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 3

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": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1568014751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 ANA DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301731",
            "telephone_number": "256-236-7509",
            "fax_number": "256-648-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 ANA DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301731",
            "telephone_number": "256-367-0920",
            "fax_number": "256-648-5842"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2129 Helton Dr",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "AL",
            "postal_code": "356301069",
            "country_code": "US",
            "telephone_number": "256-367-4916",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "234 Keller Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Tuscumbia",
            "state": "AL",
            "postal_code": "356741417",
            "country_code": "US",
            "telephone_number": "256-381-6963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMBERLY",
        "middle_name": "DAWN",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-09",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-143305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "238552",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

Verify at the official NPI Registry.