Individual provider Active NPI

Laura Smith, ARNP

  • Family Nurse Practitioner
  • Fort Walton Beach, FL
National Provider Identifier
1629422282
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9265103 Issued in FL
Practice address
514 Mary Esther Cut Off NW
Fort Walton Beach, FL 32548-4047
Phone
(850) 226-8550
Fax
(850) 226-6712
NPI assigned
Apr 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9265103 FL Primary

Addresses

Primary practice location

514 Mary Esther Cut Off NW
Fort Walton Beach, FL 32548-4047

Mailing address

514 Mary Esther Cut Off NW
Fort Walton Beach, FL 32548-4047
Phone (850) 226-8550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20171023003000 NC Practitioner - Nurse Practitioner 8123394939 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP9265103FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage Services, PC CurrentSince Oct 1, 2017 Accepting new patients

Locations

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461110400000",
    "number": "1629422282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 MARY ESTHER CUT OFF NW",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484047",
            "telephone_number": "850-226-8550",
            "fax_number": "850-226-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 MARY ESTHER CUT OFF NW",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484047",
            "telephone_number": "850-226-8550",
            "fax_number": "850-226-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LAURA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-20",
        "last_updated": "2016-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9265103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.