Spencer Smith, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9120420 Issued in FL

Practice address

4565 US Highway 17 Ste 106
Fleming Island, FL 32003-4822

Phone

(904) 269-4559

Fax

(904) 269-4597

NPI assigned

Jul 23, 2018

Last updated

Aug 25, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, FL2 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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Care Partners of Northeast Florida LLCGroup PAC ID 7214832245, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/27472/brand/1/csg/1/fhir/r4
• Direct secure messaging: spencer.smith.1@27472.direct.athenahealth.com

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.

• Family Care Partners of Northeast Florida LLC

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1750323143
  Medicare reassignment Care Compare group
• Wake Forest Health Network LLC

  dba Atrium Health Wake Forest Baptist Pediatrics - Greensboro

  • Pediatrics Physician
  • Greensboro, NC
  • NPI 1477785756
  Medicare reassignment
• Cornerstone Health Care

  dba PUA Center for Continence and Special Procedures

  • Urology Physician
  • High Point, NC
  • NPI 1588009609
  NPD
• Wake Forest Health Network, LLC

  dba Atrium Health Levine Children's Pediatrics Northwest

  • Pediatrics Physician
  • Greensboro, NC
  • NPI 1053175299
  NPD
• Family Care Partners of Northeast Florida LLC

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1114529856
  NPD (past)
• Cornerstone Health Care LLC

  • Clinical Medical Laboratory
  • Conover, NC
  • NPI 1871159145
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  Care Compare affiliation

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1679050611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W COLONIAL DR STE 303",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328046863",
            "telephone_number": "833-702-8383",
            "fax_number": "689-304-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4565 US HIGHWAY 17 STE 106",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034822",
            "telephone_number": "904-269-4559",
            "fax_number": "904-269-4597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SPENCER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-23",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9120420",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9120420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salena Sheri Smashum
• Michelle L Smith, APRN
• Rajzieta Smith, RBT
• Razzi Louella Smith
• Shayla Nicole Smith
• Ricardo Anthony Snyder, LMFT
• Tami Deabreu Snyder, PHARMD
• Neil Rohan Sood, DO
• Dante Michael Sorrentino, M.D.
• Taylor Lee Sousa, APRN

• Physician Assistant in Fleming Island, FL
• Providers in Fleming Island, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.