Individual provider Active NPI

Lisa Dawn Smith, FNP-BC

  • Family Nurse Practitioner
  • Bangor, ME
National Provider Identifier
1710354238
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP151125 Issued in ME
Practice address
55 Broadway
Suite #2
Bangor, ME 04401-5201
Phone
(207) 947-0469
Fax
(207) 947-5368
NPI assigned
Sep 1, 2015
Last updated
Sep 1, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP151125 ME Primary

Addresses

Primary practice location

55 Broadway
Suite #2
Bangor, ME 04401-5201

Mailing address

55 Broadway
Suite #2
Bangor, ME 04401-5201
Phone (207) 947-0469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20151202002577 ME Practitioner - Nurse Practitioner 4880994508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eastern Maine Medical CenterGroup PAC ID 2062315161, 659 clinicians

Practice addresses (Care Compare)

1 Northeast Dr
Northern Light Cardiology
Bangor, ME 04401-4332
Phone (207) 275-3800

302 Husson Ave
Bangor, ME 04401-3374
Phone (207) 947-6141

33 Whiting Hill Rd
Brewer, ME 04412-1021
Phone (207) 973-7478

404 State St
Bangor, ME 04401-6623

417 State St
Suite 330
Bangor, ME 04401-6638
Phone (207) 973-8881

489 State St
Bangor, ME 04401-6616
Phone (207) 973-7000

55 Broadway
Suite 2
Bangor, ME 04401-5201
Phone (207) 947-0469

7 Main Rd N
Northern Light Primary
Hampden, ME 04444-1334
Phone (207) 862-9400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.1 of 100Reported as group
Quality
64.8
Promoting interoperability
96
Improvement activities
40
Cost
68.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CNP151125MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Medical Center CurrentSince Sep 24, 2015 Accepting new patients
Eastern Maine Medical Center CurrentSince Sep 24, 2015 Accepting new patients
Norumbega Medical Specialists, LTD Past Accepting new patients

Locations

489 State St
Bangor, ME 04401
Phone (207) 973-8837

55 Broadway
#2
Bangor, ME 04401
Phone (207) 947-0469

Organizations & group practices 3

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": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1710354238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 BROADWAY",
            "address_2": "SUITE #2",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015201",
            "telephone_number": "207-947-0469",
            "fax_number": "207-947-5368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 BROADWAY",
            "address_2": "SUITE #2",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015201",
            "telephone_number": "207-947-0469",
            "fax_number": "207-947-5368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LISA",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-01",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP151125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.