Individual provider Active NPI

Susan Darlene Smith, FNP-C

  • Family Nurse Practitioner
  • Oxford, MS
National Provider Identifier
1568907392
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
901892 Issued in MS
Practice address
101 Ricky D Britt Sr Blvd
Suite 1 and 2
Oxford, MS 38655-9103
Phone
(662) 236-5442
Fax
(662) 236-5295
NPI assigned
Jan 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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 901892 MS Primary

Addresses

Primary practice location

101 Ricky D Britt Sr Blvd
Suite 1 and 2
Oxford, MS 38655-9103

Mailing address

101 Ricky D Britt Sr Blvd
Suite 1 and 2
Oxford, MS 38655-9103
Phone (662) 236-5442

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
901892MSMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1568907392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RICKY D BRITT SR BLVD",
            "address_2": "SUITE 1 AND 2",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386559103",
            "telephone_number": "662-236-5442",
            "fax_number": "662-236-5295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 RICKY D BRITT SR BLVD",
            "address_2": "SUITE 1 AND 2",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386559103",
            "telephone_number": "662-236-5442",
            "fax_number": "662-236-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SUSAN",
        "middle_name": "DARLENE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-03",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "901892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.