Fawn B Smith, NP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN175547 Issued in GA

Practice address

459 Highway 119 S
Springfield, GA 31329-3021

Phone

(912) 754-0382

Fax

(912) 754-0225

NPI assigned

Apr 30, 2015

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Surgical Providers, P.C.Group PAC ID 3274663091, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Effingham Health System Hospital, Springfield, GA, CCN 111306

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Southern Surgical Providers, P.C.

  • Surgery Physician
  • Springfield, GA
  • NPI 1619203809
  Medicare reassignment Care Compare group NPD

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

• Effingham Hospital, Inc.

  • Critical Access Hospital
  • Springfield, GA
  • NPI 1811962756
  Care Compare affiliation

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606348800000",
    "number": "1679950554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 HIGHWAY 119 S",
            "city": "SPRINGFIELD",
            "state": "GA",
            "postal_code": "313293021",
            "telephone_number": "912-754-0382",
            "fax_number": "912-754-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 HIGHWAY 119 S",
            "city": "SPRINGFIELD",
            "state": "GA",
            "postal_code": "313293021",
            "telephone_number": "912-754-0382",
            "fax_number": "912-754-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "FAWN",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-30",
        "last_updated": "2020-11-26",
        "certification_date": "2020-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN175547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fawn.smith@effinghamhospital.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7120 Hodgson Memorial Dr",
            "city": "Savannah",
            "state": "GA",
            "country_code": "US",
            "postal_code": "314062532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rocky Mountain Holdings, LLC
• Romualdo M Laygo MD PC
• Savannah Cardiology, PC
• Victoria Sikes, NP
• Ansley Smith
• Southeast Lung & Critical Care Specialists, PC
• Southern Choices LLC
• Southern Choices of the Coast
• Southern Surgical Providers, P.C.
• Southern Surgical Providers, P.C.

• Adult Health Nurse Practitioner in Springfield, GA
• Providers in Springfield, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2020; 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.