Bernetta Smith, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

277002660 Issued in IL

Practice address

11200 Lincoln Hwy
Mokena, IL 60448-8208

Phone

(866) 389-2727

NPI assigned

Oct 7, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in MS, WA, VA, FL, WV, NY, NJ, IL, MN, AZ10 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 10

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fast Pace Mississippi PLLCGroup PAC ID 3678832029, shared by 4 NPIs, 192 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southwest Ms Regional Medical Center Hospital, McComb, MS, CCN 250097

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 27)

Interoperability endpoints

• Direct secure messaging: bernetta.smith.1@19957.direct.athenahealth.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.

• Minuteclinic Diagnostic of Illinois PLLC

  • Family Nurse Practitioner
  • Mokena, IL
  • NPI 1356485809
  Medicare reassignment NPD
• Minuteclinic Video Virtual Care North, LLC

  • Family Nurse Practitioner
  • Mokena, IL
  • NPI 1518512227
  Medicare reassignment NPD
• Dwic of Tampa Bay, Inc.

  • Urgent Care Clinic/Center
  • Clearwater, FL
  • NPI 1780633834
  Medicare reassignment NPD
• Medexpress Urgent Care of Boynton Beach, LLC

  • Urgent Care Clinic/Center
  • Boynton Beach, FL
  • NPI 1366544728
  Medicare reassignment NPD
• Medexpress Urgent Care, PC - Virginia

  • Urgent Care Clinic/Center
  • Bluefield, VA
  • NPI 1215219878
  Medicare reassignment NPD
• Minuteclinic Diagnostic of Minnesota, P.a.

  • Family Nurse Practitioner
  • Eagan, MN
  • NPI 1407227945
  Medicare reassignment NPD
• Minuteclinic LLC

  • Family Nurse Practitioner
  • Rockville, MD
  • NPI 1134191836

  AZ

  Medicare reassignment NPD
• Molina Healthcare of Washington, Inc

  • Family Medicine Physician
  • Everett, WA
  • NPI 1912235060
  Medicare reassignment NPD
• Ms State Department of Health

  • Community/Behavioral Health Agency
  • Jackson, MS
  • NPI 1053489260
  Medicare reassignment NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  MS

  Medicare reassignment NPD
• Visavis Health Care Medical Group of FL, PLLC

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1871235416
  Medicare reassignment NPD
• Visavis Health Care Medical Group of NJ LLC

  • Family Medicine Physician
  • Fair Lawn, NJ
  • NPI 1881336428
  Medicare reassignment NPD

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

• Southwest Mississippi Regional Medical Center

  • General Acute Care Hospital
  • McComb, MS
  • NPI 1407805971
  Care Compare affiliation

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

{
    "created_epoch": "1507334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1619487303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25660",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049152007",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 LINCOLN HWY",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488208",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BERNETTA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-07",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "296925",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61342325",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902046",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139320",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0004355-C-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277002660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terri Lee Sharkey
• Emily Anne Shearer, MA
• Michele C. Sheehan, OTR/L
• Kaitlyn Slager
• Kathleen Josephine Slugocki, D.O.
• Diane Smith, MSN, APN, FNP-BC
• Gina Smith, LCPC
• Amy Beth So, P.T.
• Samantha Sobczak
• Amal Soloman

• Family Nurse Practitioner in Mokena, IL
• Providers in Mokena, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; 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.