Nicole A Smith, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

9561 Issued in MN

Practice address

1804 7TH St W Ste 200
Saint Paul, MN 55116-2300

Phone

(651) 227-7806

Fax

(651) 256-6710

NPI assigned

Jan 20, 2022

Reactivated

Oct 5, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Nicole A O'Dell Former name

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 and National Provider Directory roles.

• Dakota Pediatrics, P.a.

  • Primary Care Clinic/Center
  • Inver Grove Heights, MN
  • NPI 1285943027
  NPD (past)

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1669124756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 AMERICAN BLVD W STE 300",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554314442",
            "telephone_number": "952-512-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 7TH ST W STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551162300",
            "telephone_number": "651-227-7806",
            "fax_number": "651-256-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICOLE",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-20",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "deactivation_date": "2022-09-24",
        "reactivation_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "243890-0",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "9561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "O'DELL",
            "middle_name": "A",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Margaret L Smith, N.P.
• Maria Jensen Smith
• Mary Jo Smith, CRNA
• Matthew W Smith, MD
• Michael Smith, M.D.
• Rachel Smith
• Samantha E Smith, OTR/L
• Shara Smith
• Teresa Smith
• Smiths Medical MD Inc

• Nurse Practitioner in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.