Justin Smith, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R157238 Issued in MD

Practice address

1113 Church St
Conway, SC 29526-4128

Phone

(843) 248-6269

NPI assigned

Sep 13, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jsmith550092@direct.umm.edu

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.

• Chester River Hospital Center

  • General Acute Care Hospital
  • Chestertown, MD
  • NPI 1679536809
  Medicare reassignment NPD
• Doctors Emergency Service, PA

  • Emergency Medicine Physician
  • Annapolis, MD
  • NPI 1528171840
  Medicare reassignment NPD
• Emergency Medicine Associates P.a., P.C.

  • Emergency Medicine Physician
  • Falls Church, VA
  • NPI 1134117393

  DC, MD

  Medicare reassignment NPD
• Upper Chesapeake Emergency Medicine Physicians, LLC

  • Emergency Medicine Physician
  • Bel Air, MD
  • NPI 1285854026
  Medicare reassignment NPD
• Chester River Health Center

  • Clinic/Center
  • Chestertown, MD
  • NPI 1114290293
  NPD
• Chester River Hospital Center

  • Emergency Medicine Physician
  • Chestertown, MD
  • NPI 1053491795
  NPD
• Emergency Medicine Associates P.a., P.C.

  • Internal Medicine Physician
  • Culpeper, VA
  • NPI 1881559102
  NPD
• Emergency Medicine Associates, PA

  • Emergency Medicine Physician
  • Cambridge, MD
  • NPI 1083465033
  NPD

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1598015828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MEDICAL PARKWAY",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21401",
            "telephone_number": "443-481-1366",
            "fax_number": "443-481-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 CHURCH ST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295264128",
            "telephone_number": "843-248-6269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Medical Parkway",
            "address_purpose": "LOCATION",
            "city": "Annapolis",
            "state": "MD",
            "postal_code": "21401",
            "country_code": "US",
            "telephone_number": "443-481-1366",
            "fax_number": "443-481-1370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JUSTIN",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-13",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R157238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Edward Smith
• Courtney Jeanette Smith
• Dale Smith, RN, MPH, MSN
• Emily Smith
• Eric Levern Smith Sr., MENTAL HEALTH COUNS
• Karen Jeanette Smith, CRNP
• Karen P Smith, RN
• Larry Smith
• Maritta Janice Smith
• Mary Elizabeth Smith

• Family Nurse Practitioner in Conway, SC
• Providers in Conway, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.