Mary Jane Smith, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

1-112783 Issued in AL

Practice address

3750 Professional Pkwy
Mobile, AL 36609-5407

Phone

(251) 460-0999

NPI assigned

Aug 5, 2019

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 identifiers 5

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Cancer Center PCGroup PAC ID 5597860403, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• USA Health HCA Providence Hospital, LLC Hospital, Mobile, AL, CCN 010090

Merit-based Incentive Payment System (MIPS)

Final score

91.81 of 100Reported as subgroup

Quality

91.87

Promoting interoperability

100

Improvement activities

40

Cost

71.54

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.smith@southerncancercenter.ikm.direct-ci.com

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.

• Southern Cancer Center, PC

  • Medical Oncology Physician
  • Mobile, AL
  • NPI 1578629556
  Medicare reassignment Care Compare group NPD
• Southern Cancer Center, PC

  dba Coastal Pharmacy Springhill

  • Pharmacy
  • Mobile, AL
  • NPI 1568142099
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• USA Health HCA Providence Hospital LLC

  dba USA Health Providence Hospital

  • General Acute Care Hospital
  • Mobile, AL
  • NPI 1992489223
  Care Compare affiliation

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1598310740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29653 ANCHOR CROSS BLVD",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365269594",
            "telephone_number": "251-625-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 PROFESSIONAL PKWY",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366095407",
            "telephone_number": "251-460-0999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Mobile Infirmary Cir Ste 302",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366073515",
            "country_code": "US",
            "telephone_number": "251-625-6896",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6701 Airport Blvd.",
            "address_2": "B Bldg., T Level",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366083764",
            "country_code": "US",
            "telephone_number": "251-625-6896",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3719 Dauphin St Fl 5",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366081753",
            "country_code": "US",
            "telephone_number": "251-625-6896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARY",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "1-112783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "245903",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P02453396",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "246049",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A871121V",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "248711",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Ray Smith II, APRN
• Kimberly Ann Graham Smith, PH.D., CCC-SLP
• Kyler Weston Smith, MD
• Macy Smith
• Mary Barrett Smith, LICSW
• Megan Kennedy Smith, NNP-BC, CRNP
• Megan Renee Smith, PHARM.D.
• Michael A Smith, PA
• Miranda Jane Smith, NP-C
• Nathan Dwayne Smith, R.PH.

• Adult Health Nurse Practitioner in Mobile, AL
• Providers in Mobile, AL by specialty
• Adult Health Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.