Individual provider Active NPI

Kristina Marie Smith, APN-BC

  • Adult Health Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1790937357
Registry record updated Oct 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN160488 NP Issued in GA
Practice address
11700 Mercy Blvd
Plaza D
Savannah, GA 31419-1753
Phone
(912) 920-8898
NPI assigned
Oct 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN160488 NP GA Primary

Addresses

Primary practice location

11700 Mercy Blvd
Plaza D
Savannah, GA 31419-1753

Mailing address

11700 Mercy Blvd
Plaza D
Savannah, GA 31419-1753
Phone (912) 920-8898

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN160488 NPGAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amw, Inc. Past Accepting new patients
St. Joseph'S Medical Group, LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224028800000",
    "number": "1790937357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11700 MERCY BLVD",
            "address_2": "PLAZA D",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191753",
            "telephone_number": "912-920-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 MERCY BLVD",
            "address_2": "PLAZA D",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191753",
            "telephone_number": "912-920-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "APN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-15",
        "last_updated": "2008-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN160488 NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.