Brenda L Smoot, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R856673 Issued in MS

Practice address

1500 E Woodrow Wilson Ave
None
Jackson, MS 39216-5116

Phone

(601) 362-4471

Fax

(601) 364-1357

NPI assigned

Aug 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Brenda L Harris Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Vicksburg Clinic LLC

  • Infectious Disease Physician
  • Vicksburg, MS
  • NPI 1659307791
  NPD (past)
• Vicksburg Clinic LLC

  • Family Medicine Physician
  • Vicksburg, MS
  • NPI 1790711158
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568572055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 S SIWELL RD",
            "address_2": "NONE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392126209",
            "telephone_number": "601-362-4471",
            "fax_number": "601-364-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E WOODROW WILSON AVE",
            "address_2": "NONE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165116",
            "telephone_number": "601-362-4471",
            "fax_number": "601-364-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOOT",
        "first_name": "BRENDA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R856673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "HARRIS",
            "middle_name": "L",
            "prefix": "MRS.",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Victor Oneil Smith, CEO/COO
• Yolanda Smith
• Yolonda Coleman Smith, AGACNP
• Lynne E Smithhart
• Erica Smolinski, PHD
• Lisa L Smoots-Levy, OWNER
• SMS Care of Ms, LLC
• Heath Herndon Smylie
• Aubrey Ruth Smyly
• Andrew T Smyth, MD

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.