Individual provider Active NPI

Nicholas Alexander Smith, D.O

  • Sports Medicine (Family Medicine) Physician
  • Gainesville, FL
National Provider Identifier
1629203815
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
OS20600 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone
(352) 273-5159
NPI assigned
May 18, 2009
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS20600 FL
Sports Medicine (Internal Medicine) Physician 207RS0010X 14269 ND
Sports Medicine (Family Medicine) Physician 207QS0010X OS20600 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-3003

Mailing address

2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-6468

Other practice location 1

4440 S Washington St
Grand Forks, ND 58201
Phone (701) 732-7700

Other identifiers 1

IdentifierTypeStateIssuer
120820900MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nsmith98098@direct.directaltru.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160923001042 ND Practitioner - Sports MedicinePractitioner - Family Practice 8426273277 Reassigns benefits to 1 organization
I20240219001500 FL Practitioner - Family PracticePractitioner - Sports Medicine 8426273277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1600 SW Archer
Gainesville, FL 32610-3003

1600 SW Archer Rd
Gainesville, FL 32610-3003

1600 SW Archer Rd RM
1191 Uf Health Surgical Specialists Shands
Gainesville, FL 32610-3003
Phone (352) 265-0535

1701 N Main St
Uf Health Family Medicine Main Center
Gainesville, FL 32609-3650
Phone (352) 265-7001

2000 SW Archer Rd
Uf Health Congenital Heart Center Medical P
Gainesville, FL 32610-3003
Phone (352) 265-8250

2001 SW 13TH St
Gainesville, FL 32608-1532
Phone (352) 265-8990

3450 Hull Rd
Gainesville, FL 32607-4144

3450 SW Hull Rd
Uf Health Pediatric Urology Osmi
Gainesville, FL 32607-4144
Phone (352) 265-8240

3480 Hull Rd
Gainesville, FL 32607-4144
Phone (352) 338-7100

Uf Health Test Site Pop Up 1600 SW Ar
Gainesville, FL 32610-3003
Phone (352) 392-1161

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS20600FLMDFamily Medicine Physician
14269NDMDSports Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System Family Medicine CurrentSince Jan 6, 2020 Accepting new patients
Florida Clinical Practice Association Inc Family Medicine CurrentSince Jan 22, 2024 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jan 22, 2024 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

1707 N Main St
Gainesville, FL 32609
Phone (352) 265-9592

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

3450 Hull Rd
Gainesville, FL 32607
Phone (352) 273-7002

400 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9100

607 Demers Ave
East Grand Forks, MN 56721
Phone (218) 773-0357

19120 200th St
Greenbush, MN 56726
Phone (218) 782-2400

711 Delmore Dr
Roseau, MN 56751
Phone (218) 463-1365

412 Main Ave NE
Warroad, MN 56763
Phone (218) 386-2020

1200 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5243

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

4440 S Washington St
Grand Forks, ND 58201
Phone (701) 732-7000

Interoperability endpoints

  • Direct secure messaging: nsmith660578@direct.shands.ufl.edu
  • Direct secure messaging: nsmith98098@direct.directaltru.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1242604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1629203815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-780-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-273-5159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4440 S Washington St",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "58201",
            "country_code": "US",
            "telephone_number": "701-732-7700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICHOLAS",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-18",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS20600",
            "primary": false
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "ND",
            "license": "14269",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "OS20600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120820900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nsmith98098@direct.directaltru.org",
            "affiliation": "N",
            "endpointDescription": "direct mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4440 S Washington St",
            "city": "Grand Forks",
            "state": "ND",
            "country_code": "US",
            "postal_code": "58201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.