Phylicia Diana Smith, PNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

5020638 Issued in NC

Practice address

506 Pollock St
New Bern, NC 28562-5612

Phone

(252) 288-6325

NPI assigned

Aug 22, 2024

Last updated

Aug 22, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Southmountain Children and Family Services

  • Professional Counselor
  • Nebo, NC
  • NPI 1467763797
  NPD (past)

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

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1629801865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 RED WILLOW LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271277003",
            "telephone_number": "336-406-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 POLLOCK ST",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625612",
            "telephone_number": "252-288-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PHYLICIA",
        "middle_name": "DIANA",
        "credential": "PNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5020638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Smith, PT, DPT
• Lindsey Noelle Smith, MA/CCC-SLP
• Lysesha R Smith
• Mark S Smith
• Natalie Burns Smith, PA
• Sarah Smith
• Searra Smith
• Sesia Roberts Smith, RPH
• SNH NC Tenant LLC (MCarthy Court II)
• SNH NC Tenant LLC (Home Place of New Bern)

• Pediatric Nurse Practitioner in New Bern, NC
• Providers in New Bern, NC by specialty
• Pediatric Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.