Individual provider Active NPI

Nicole Smith, FNP

  • Nurse Practitioner
  • Bend, OR
National Provider Identifier
1568822864
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
201905762NP-PP Issued in OR
Practice address
2500 NE Neff Rd
Bend, OR 97701-6015
Phone
(541) 388-4333
Fax
(541) 388-3446
NPI assigned
Feb 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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 201905762NP-PP OR Primary
Family Nurse Practitioner 363LF0000X 5008394 NC

Addresses

Primary practice location

2500 NE Neff Rd
Bend, OR 97701-6015

Mailing address

PO Box 6048
Bend, OR 97708-6048
Phone (541) 382-4900

Other practice location 1

1501 NE Medical Center Dr
Bend, OR 97701-6051
Phone (541) 382-4900

Other identifiers 1

IdentifierTypeStateIssuer
500788384MedicaidOR

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nsmith114346@secure.stcharleshealthcare.org
Direct Messaging Address nsmith18002@directmsg.bmctotalcare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20201215001691 OR Practitioner - Nurse Practitioner 5496045338 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bend Memorial Clinic PCGroup PAC ID 7214936533, 225 clinicians
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

1501 NE Medical Ctr Dr
Bend, OR 97701-6051
Phone (541) 382-2811

2500 NE Neff Rd
Pulmonary Clin
Bend, OR 97701-6015
Phone (541) 706-7715

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201905762NP-PPORMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bend Memorial Clinic PC Nurse Practitioner Current Accepting new patients
St. Charles Health System, Inc. CurrentSince Nov 17, 2025 Accepting new patients
Bend Memorial Clinic PC CurrentSince Feb 8, 2021 Accepting new patients
St. Charles Health System, Inc. CurrentSince Nov 17, 2025 Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

929 SW Simpson Ave
Bend, OR 97702
Phone (541) 848-6642

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

559 W Washington St
Burns, OR 97720
Phone (541) 573-2074

271 N Egan Ave
Burns, OR 97720
Phone (541) 573-2301

180 Ford Rd
John Day, OR 97845
Phone (541) 575-0404

51781 Huntington Rd
La Pine, OR 97739
Phone (541) 666-7920

700 S J St
Lakeview, OR 97630
Phone (541) 947-2114

480 NE A St
Madras, OR 97741
Phone (541) 475-4800

384 SE Combs Flat Rd
Prineville, OR 97754
Phone (541) 383-3668

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

630 N Arrowleaf Trl
Sisters, OR 97759
Phone (541) 549-1318

Interoperability endpoints

  • Direct secure messaging: nsmith114346@secure.stcharleshealthcare.org
  • Direct secure messaging: nsmith18002@directmsg.bmctotalcare.com

Organizations & group practices 4

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": "1456704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1568822864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6048",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977086048",
            "telephone_number": "541-382-4900",
            "fax_number": "541-706-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NE NEFF RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016015",
            "telephone_number": "541-388-4333",
            "fax_number": "541-388-3446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 NE Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977016051",
            "country_code": "US",
            "telephone_number": "541-382-4900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICOLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-29",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201905762NP-PP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008394",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500788384",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nsmith114346@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "2500 NE Neff Rd",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977016015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nsmith18002@directmsg.bmctotalcare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1501 NE Medical Center Dr",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977016051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.