Individual provider Active NPI

Brittany Lynne Smith, PA

  • Physician Assistant
  • Dover, NH
National Provider Identifier
1750970497
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2864 Issued in NH
Practice address
784 Central Ave
Dover, NH 03820-2549
Phone
(603) 742-5556
Fax
(603) 742-8668
NPI assigned
Jan 17, 2021
Last updated
Sep 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X PA8568 MA
Physician Assistant 363A00000X 2864 NH Primary
Student in an Organized Health Care Education/Training Program 390200000X MA

Addresses

Primary practice location

784 Central Ave
Dover, NH 03820-2549

Mailing address

15 Spaulding St
Townsend, MA 01469-1114
Phone (978) 809-5668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220419001128 MA Practitioner - Physician Assistant 1355738527 Reassigns benefits to 2 organizations
I20240828001762 NH Practitioner - Physician Assistant 1355738527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Campbell Dermatology PAGroup PAC ID 9537154059, 19 clinicians

Practice addresses (Care Compare)

2299 Woodbury Ave
Suite 3
Newington, NH 03801-7854
Phone 603742555631

784 Central Ave
Dover, NH 03820-2549
Phone (603) 742-5556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2864NHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology and Skin Health LLC CurrentSince Aug 18, 2024 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Mar 1, 2023 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Mar 1, 2023 Accepting new patients

Locations

784 Central Ave
Dover, NH 03820
Phone (603) 742-5556

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": "1610841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1750970497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SPAULDING ST",
            "city": "TOWNSEND",
            "state": "MA",
            "postal_code": "014691114",
            "telephone_number": "978-809-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202549",
            "telephone_number": "603-742-5556",
            "fax_number": "603-742-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRITTANY",
        "middle_name": "LYNNE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-17",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA8568",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "2864",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.