Jeremiah Shane Smith, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

16902 Issued in TN

Practice address

605 Glenwood Drive, Suite 105
CHI Memorial Thoracic Oncology Associates
Chattanooga, TN 37404

Phone

(423) 495-5864

Fax

(423) 495-2065

NPI assigned

Nov 7, 2012

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Memorial Health Partners Foundation IncGroup PAC ID 8022919570, 458 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Healthcare System, Inc Hospital, Chattanooga, TN, CCN 440091
• Commonspirit-Memorial Hospital-North Georgia Hospital, Ringgold, GA, CCN 110236
• Rhea Medical Center Hospital, Dayton, TN, CCN 441310

Merit-based Incentive Payment System (MIPS)

Final score

94.27 of 100Reported as apm

Quality

92.6

Promoting interoperability

93.23

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeremiahsmith@tnmhpf.allscriptsdirect.net
• Direct secure messaging: jsmith132128@direct.stlukeshealth.org

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.

• Memorial Health Partners Foundation, Inc

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1922053545
  Medicare reassignment Care Compare group NPD
• Memorial Health Partners Foundation Inc

  dba CHI Memorial Family Practice Associates - Trenton

  • Rural Health Clinic/Center
  • Trenton, GA
  • NPI 1467602482
  NPD
• Memorial Health Partners Foundation Inc

  dba CHI Memorial Family Practice Associates - Lafayette

  • Rural Health Clinic/Center
  • La Fayette, GA
  • NPI 1760632780
  NPD
• Mid-South Surgical Associates PLLC

  dba Alliance of Cardiac, Thoracic & Vascular Surgeons

  • Specialist
  • Chattanooga, TN
  • NPI 1811941396
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Health Care System Inc.

  dba Memorial Hospital Hixson

  • General Acute Care Hospital
  • Hixson, TN
  • NPI 1083778633
  Care Compare affiliation
• Memorial Health Care System Inc.

  dba Memorial Hospital

  • General Acute Care Hospital
  • Chattanooga, TN
  • NPI 1255428736
  Care Compare affiliation
• Rhea Medical Center

  • Critical Access Hospital
  • Dayton, TN
  • NPI 1811987084
  Care Compare affiliation
• CHI Memorial Hospital - Georgia

  • General Acute Care Hospital
  • Ringgold, GA
  • NPI 1356860621
  Care Compare affiliation

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790039188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1949 GUNBARREL ROAD",
            "address_2": "SUITE 230",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37421",
            "telephone_number": "423-495-4349",
            "fax_number": "423-495-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 GLENWOOD DRIVE, SUITE 105",
            "address_2": "CHI MEMORIAL THORACIC ONCOLOGY ASSOCIATES",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37404",
            "telephone_number": "423-495-5864",
            "fax_number": "423-495-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEREMIAH",
        "middle_name": "SHANE",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "APN0000016902",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "16902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN LICENSE",
            "identifier": "16902",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Helen Smith, NP
• James Clifford Smith
• Janice L Smith, RN
• Jason Gregory Smith, MD
• Jennifer K Smith, D.C.
• Jerry Lee Smith, MD
• Jessica Allaway Smith, MD
• John Kevin Smith Jr., MD
• Jonathan Hillel Smith, LCSW
• Josh M Smith, MD

• Acute Care Nurse Practitioner in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Acute Care Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.