Brent Smith CRNP

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

BRENT SMITH CRNP

Doing business as

Mindspace Medical

Practice address

150 Mundy St
Wilkes Barre, PA 18702-6830

Phone

(570) 260-6500

NPI assigned

Jun 17, 2024

Last updated

Jun 17, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brent Smith, NPNPI 1376186064

Title

Medical Director

Phone

(570) 260-6500

Specialties & licenses 1

Addresses

Other names 1

• Mindspace Medical Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brent Tyler Smith, NP

  • Nurse Practitioner
  • Wilkes Barre, PA
  • NPI 1376186064
  NPD Authorized official

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1710720990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 DANA ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187025755",
            "telephone_number": "570-260-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MUNDY ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187026830",
            "telephone_number": "570-260-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT SMITH CRNP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-16",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "570-260-6500",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindspace Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bradley D Fenster MD PHD PC
• James O. Brady, M.D.
• Tyler Brady I
• William F Brazerol, MD
• Amy Brazil Golden
• Herbert C Bressler III, O.D.
• Brian Odonnell, OD PC
• Angela Maria Brigandi
• Myeson Brigerman
• Karen A Briggs, RPH

• Psychiatry Physician in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.