Individual provider Active NPI

Brenda Ann Smith, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Independence, KY
National Provider Identifier
1780207043
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3014639 Issued in KY
Practice address
10189 Chestnut Oak Dr
Independence, KY 41051-8805
Phone
(859) 663-8670
NPI assigned
May 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 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 3014639 KY Primary

Addresses

Primary practice location

10189 Chestnut Oak Dr
Independence, KY 41051-8805

Mailing address

10189 Chestnut Oak Dr
Independence, KY 41051-8805
Phone (859) 663-8670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20200831001746 KY Practitioner - Nurse Practitioner 9739506114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

Practice addresses (Care Compare)

100 Executive Park
Suite 103
Louisville, KY 40207-4201
Phone (502) 552-5068

250 Grandview Dr
Suite 575
Ft Mitchell, KY 41017-5641
Phone (859) 486-2808

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3014639KYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological & Behavioral Consultants, LLC CurrentSince Jun 1, 2022 Accepting new patients

Locations

20 N Grand Ave
Ste 15
Fort Thomas, KY 41075
Phone (513) 975-4673

250 Grandview Dr
Ste 575
Ft Mitchell, KY 41017
Phone (317) 292-7108

100 Executive Park
Ste 103
Louisville, KY 40207
Phone (502) 313-6880

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.brendasmith@140097.advancedmd-direct.com

Organizations & group practices 1

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 1

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": "1590019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1780207043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10189 CHESTNUT OAK DR",
            "city": "INDEPENDENCE",
            "state": "KY",
            "postal_code": "410518805",
            "telephone_number": "859-663-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10189 CHESTNUT OAK DR",
            "city": "INDEPENDENCE",
            "state": "KY",
            "postal_code": "410518805",
            "telephone_number": "859-663-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRENDA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-21",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3014639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, KY

Sources for this page

Verify at the official NPI Registry.