Individual provider Active NPI

David G Smiley, APNP

  • Family Nurse Practitioner
  • Watertown, WI
National Provider Identifier
1720709751
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12142-33 Issued in WI
Practice address
1507 Doctors CT
Watertown, WI 53094-4101
Phone
(920) 261-4111
NPI assigned
Sep 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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 12142-33 WI Primary

Addresses

Primary practice location

1507 Doctors CT
Watertown, WI 53094-4101

Mailing address

1507 Doctors CT
Watertown, WI 53094-4101
Phone (920) 261-4111

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL dsmiley@watertownregional.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20221219002697 WI Practitioner - Nurse Practitioner 0547639270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watertown Physician Practices LLCGroup PAC ID 8022329408, 64 clinicians

Practice addresses (Care Compare)

1507 Doctors CT
Watertown, WI 53094-4101
Phone (920) 261-4111

Hospital & facility affiliations

  • Commonheart Home Health Home health agency, Waukesha, WI, CCN 527151
  • Watertown Memorial Hospital Hospital, Watertown, WI, CCN 520116

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Watertown Physician Practices LLC Family Current Accepting new patients
Watertown Physician Practices LLC CurrentSince Nov 1, 2022 Accepting new patients

Locations

540 Village Walk Ln
Ste J
Johnson Creek, WI 53038
Phone (920) 699-4388

334 S Western Ave
Juneau, WI 53039
Phone (920) 261-9610

1025 Mulberry St
Lake Mills, WI 53551
Phone (920) 261-9591

111 Anna St
Waterloo, WI 53594
Phone (920) 478-3776

1507 Doctors Ct
Watertown, WI 53094
Phone (920) 261-4111

132 Hospital Dr
Watertown, WI 53098
Phone (920) 206-7797

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1720709751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 DOCTORS CT",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530944101",
            "telephone_number": "920-261-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 DOCTORS CT",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530944101",
            "telephone_number": "920-261-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMILEY",
        "first_name": "DAVID",
        "middle_name": "G",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "12142-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "dsmiley@watertownregional.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1507 Doctors Ct",
            "city": "Watertown",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530944101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

Verify at the official NPI Registry.