Individual provider Active NPI

Amanda B Smith, NP

  • Nurse Practitioner
  • Lake Mary, FL
National Provider Identifier
1649672775
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9447525 Issued in FL
Practice address
775 Primera Blvd Ste 1031
Lake Mary, FL 32746-2190
Phone
(407) 603-1633
NPI assigned
Sep 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9447525 FL
Nurse Practitioner 363L00000X ARNP9447525 FL
Nurse Practitioner 363L00000X 9447525 FL Primary

Addresses

Primary practice location

775 Primera Blvd Ste 1031
Lake Mary, FL 32746-2190

Mailing address

775 Primera Blvd Ste 1031
Lake Mary, FL 32746-2190
Phone (407) 603-1633

Other practice location 1

525 N Park Ave Ste 218
Winter Park, FL 32789-3227
Phone (407) 720-5119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170915000246 FL Practitioner - Nurse Practitioner 5294059713 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairbanks Partners LLCGroup PAC ID 8820303621, 37 clinicians

Practice addresses (Care Compare)

12323 W Colonial Dr
Suite 220
Winter Arden, FL 34787-4179
Phone (407) 975-0200

400 Celebration PL
Celebration, FL 34747-4970
Phone (407) 975-0200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19056TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spinecare Associates, LLC CurrentSince Jun 26, 2017 Accepting new patients
The Clearwater Orthopaedic ASC LLC Past Accepting new patients
SC Physicians LLC PastSince Mar 27, 2018 Accepting new patients
Orlando Neurosurgery, P.a. Past Accepting new patients

Locations

2250 Drew St
Clearwater, FL 33765
Phone (813) 797-7463

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: amandasmith@fsispine.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1649672775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 PRIMERA BLVD STE 1031",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462190",
            "telephone_number": "407-603-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 PRIMERA BLVD STE 1031",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462190",
            "telephone_number": "407-603-1633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 N Park Ave Ste 218",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327893227",
            "country_code": "US",
            "telephone_number": "407-720-5119",
            "fax_number": "407-610-1317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMANDA",
        "middle_name": "B",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-19",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9447525",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9447525",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9447525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.