Individual provider Active NPI

Jennifer Smith, APN FNP

  • Nurse Practitioner
  • Princeton, IN
National Provider Identifier
1659162980
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71017893A Issued in IN
Practice address
1414 W Broadway St
Princeton, IN 47670-1142
Phone
(812) 385-5283
Fax
(812) 385-5274
NPI assigned
May 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 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 209-031499 IL
Nurse Practitioner 363L00000X 71017893A IN Primary
Nurse Practitioner 363L00000X 209-031499 IL

Addresses

Primary practice location

1414 W Broadway St
Princeton, IN 47670-1142

Mailing address

1414 W Broadway St
Princeton, IN 47670-1142
Phone (812) 385-5283

Other practice location 1

303 NW 11th St
Fairfield, IL 62837-1206
Phone (618) 842-4617

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20250613001454 IL Practitioner - Nurse Practitioner 0648781096 Reassigns benefits to 1 organization
I20260430001343 IN Practitioner - Nurse Practitioner 0648781096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairfield Memorial Hospital AssociationGroup PAC ID 5698671741, shared by 4 NPIs, 32 clinicians
Deaconess Clinic IncGroup PAC ID 3375610116, 411 clinicians

Practice addresses (Care Compare)

213 NW 10TH St
Fairfield, IL 62837-1219

3150 Warrick Dr
Boonville, IN 47601-8602
Phone (812) 858-3355

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209-031499ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfield Memorial Hospital Association Current Accepting new patients
Fairfield Memorial Hospital Association CurrentSince Jun 6, 2025 Accepting new patients
Fairfield Memorial Hospital Association CurrentSince Jun 6, 2025 Accepting new patients

Locations

303 NW 11th St
Fairfield, IL 62837
Phone (618) 842-2611

213 NW 10th St
Ste A
Fairfield, IL 62837
Phone (618) 842-4617

Interoperability endpoints

  • Direct secure messaging: jlsmith@direct.horizonhealthcare.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://api.platform.athenahealth.com/11356/brand/1/csg/161/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1747267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1659162980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 W BROADWAY ST",
            "city": "PRINCETON",
            "state": "IN",
            "postal_code": "476701142",
            "telephone_number": "812-385-5283",
            "fax_number": "812-385-5274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W BROADWAY ST",
            "city": "PRINCETON",
            "state": "IN",
            "postal_code": "476701142",
            "telephone_number": "812-385-5283",
            "fax_number": "812-385-5274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 NW 11th St",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "IL",
            "postal_code": "628371206",
            "country_code": "US",
            "telephone_number": "618-842-4617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "credential": "APN FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-15",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-031499",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71017893A",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-031499",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, IN

Sources for this page

Verify at the official NPI Registry.