Individual provider Active NPI

Daniel Lee Smith

  • Psychiatric/Mental Health Nurse Practitioner
  • Mooresville, NC
National Provider Identifier
1730052168
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5023102 Issued in NC
Practice address
378 Williamson Rd Ste 204
Mooresville, NC 28117-5917
Phone
(704) 978-8334
NPI assigned
Sep 23, 2025
Last updated
Sep 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5023102 NC Primary

Addresses

Primary practice location

378 Williamson Rd Ste 204
Mooresville, NC 28117-5917

Mailing address

6917 Reeps Grove Church Rd
Vale, NC 28168-6739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20260317001072 NC Practitioner - Nurse Practitioner 5395228423 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Ivy Advanced Practice Health, PLLCGroup PAC ID 3375989619, 2 clinicians

Practice addresses (Care Compare)

103 Billinsgate CT
Mooresville, NC 28117-6702
Phone (704) 880-1466

432 Hospital Dr
Linville, NC 28646-3026
Phone (828) 262-9168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5023102NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charles a Cannon Jr Memorial Hospital Inc Single Specialty CurrentSince Jan 26, 2026 Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc Single Specialty CurrentSince Jan 26, 2026 Accepting new patients
Appalachian Regional Behavioral Healthcare Inc CurrentSince Jan 26, 2026 Accepting new patients
Appalachian Regional Behavioral Healthcare Inc Single Specialty CurrentSince Jan 26, 2026 Accepting new patients
Ivy Advanced Practice Health, PLLC Single Specialty CurrentSince Sep 28, 2025 Accepting new patients

Locations

378 Williamson Rd
Ste 204
Mooresville, NC 28117
Phone (704) 662-0009

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1758585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1730052168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6917 REEPS GROVE CHURCH RD",
            "city": "VALE",
            "state": "NC",
            "postal_code": "281686739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 WILLIAMSON RD STE 204",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175917",
            "telephone_number": "704-978-8334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DANIEL",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-23",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5023102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.