Individual provider Active NPI

Jenna Nicole Smith, WHNP

  • Women's Health Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1598355117
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
71012988A Issued in IN
Practice address
3700 Washington Ave # 2200
Evansville, IN 47714-0541
Phone
(812) 485-7111
NPI assigned
Jan 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 209022032 IL
Women's Health Nurse Practitioner 363LW0102X 71012988A IN Primary

Addresses

Primary practice location

3700 Washington Ave # 2200
Evansville, IN 47714-0541

Mailing address

84 W 800 S Apt 4108
Fort Branch, IN 47648-8658
Phone (618) 302-7752

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jenna.smith.1@7598.direct.athenahealth.com St Mary's Medical Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20220914001044 IN Practitioner - Nurse Practitioner 4789069642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians

Practice addresses (Care Compare)

3700 Washington Ave
Suite 2200
Evansville, IN 47714-0541
Phone (812) 485-7111

Hospital & facility affiliations

  • Ascension St Vincent Evansville Hospital, Evansville, IN, CCN 150100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209022032ILMDWomen's Health Nurse Practitioner
71012988AINMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary'S Medical Group, LLC CurrentSince Sep 4, 2022 Accepting new patients
St Mary'S Medical Group, LLC CurrentSince Sep 4, 2022 Accepting new patients
St. Mary'S Physician Network LLC. CurrentSince Dec 6, 2022 Accepting new patients
St. Mary'S Health, Inc Women'S Health Past Accepting new patients
St Vincent Physician Services Hospital and Health Care Center PastSince Dec 6, 2022 Accepting new patients

Locations

801 Saint Marys Dr
Ste 505E
Evansville, IN 47714
Phone (812) 491-3236

14020 Old State Rd
Ste C200
Evansville, IN 47725
Phone (812) 469-4700

3700 Washington Ave
#2200
Evansville, IN 47714
Phone (812) 485-7111

516 Court St
#A
Evansville, IN 47708
Phone (812) 485-2100

100 S Rosenberger Ave
Ste B300
Evansville, IN 47712
Phone (812) 485-7111

3700 Washington Ave
Ste 2200
Evansville, IN 47714
Phone (812) 485-7111

7839 S Professional Dr
Fort Branch, IN 47648
Phone (812) 753-5903

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

Organizations & group practices 5

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 1

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": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1598355117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 W 800 S APT 4108",
            "city": "FORT BRANCH",
            "state": "IN",
            "postal_code": "476488658",
            "telephone_number": "618-302-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON AVE # 2200",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140541",
            "telephone_number": "812-485-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNA",
        "middle_name": "NICOLE",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209022032",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IN",
            "license": "71012988A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jenna.smith.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "3700 Washington Ave # 2200",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477140541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.