Active NPI
Bridgette Carson-Smith
- Adult Companion
- Fort Pierce, FL
National Provider Identifier
1750034112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- Practice address
- 2307 Avienda Ave
Fort Pierce, FL 34946-1144 - Phone
- (772) 332-0749
- NPI assigned
- Jan 26, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Companion | 372600000X | Primary |
Addresses
Primary practice location
2307 Avienda Ave
Fort Pierce, FL 34946-1144
Mailing address
2307 Avienda Ave
Fort Pierce, FL 34946-1144
Phone (772) 332-0749
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 687911096 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643155200000",
"number": "1750034112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2307 AVIENDA AVE",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349461144",
"telephone_number": "772-332-0749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2307 AVIENDA AVE",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349461144",
"telephone_number": "772-332-0749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARSON-SMITH",
"first_name": "BRIDGETTE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-26",
"last_updated": "2022-01-26",
"certification_date": "2022-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "687911096",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Pierce, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.