Individual provider Active NPI

Suzann Smith, APRN

  • Family Nurse Practitioner
  • Manchester, KY
National Provider Identifier
1811220171
Registry record updated Jan 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3006246 Issued in KY
Practice address
56 Marie Langdon Dr
Manchester, KY 40962-6329
Phone
(606) 599-4080
Fax
(606) 712-1200
NPI assigned
Sep 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3006246 KY
Family Nurse Practitioner 363LF0000X 3006246 KY Primary

Addresses

Primary practice location

56 Marie Langdon Dr
Manchester, KY 40962-6329

Mailing address

11217 Highway 421 S
Tyner, KY 40486-8352
Phone (606) 598-5104

Other practice location 1

375 Town Branch Rd Ste 2
Manchester, KY 40962-1326
Phone (606) 598-0070

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
I20091107000018 KY Practitioner - Nurse Practitioner 2062550320 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital, Inc.Group PAC ID 4486616141, shared by 9 NPIs, 60 clinicians

Practice addresses (Care Compare)

56 Marie Langdon Dr
Manchester, KY 40962-6329
Phone (606) 599-4080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3006246KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Inc. Family CurrentSince Sep 17, 2009 Accepting new patients
Bouncing Back Counseling Inc CurrentSince Jun 13, 2023 Accepting new patients
Memorial Hospital, Inc. Family Current Accepting new patients
Memorial Hospital, Inc. CurrentSince Sep 17, 2009 Accepting new patients

Locations

509 Memorial Dr
Ste 2
Manchester, KY 40962
Phone (606) 598-4384

210 Marie Langdon Dr
Manchester, KY 40962
Phone (865) 985-7047

375 Town Branch Rd
#2
Manchester, KY 40962
Phone (606) 598-0070

94 Marie Langdon Dr
Ste 2
Manchester, KY 40962
Phone (606) 599-0200

1033 N Highway 11
Manchester, KY 40962
Phone (606) 598-6163

Interoperability endpoints

  • Direct secure messaging: ssmith659438@adventhealth.direct-ci.com

Organizations & group practices 4

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": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674259200000",
    "number": "1811220171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11217 HIGHWAY 421 S",
            "city": "TYNER",
            "state": "KY",
            "postal_code": "404868352",
            "telephone_number": "606-598-5104",
            "fax_number": "606-712-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 MARIE LANGDON DR",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409626329",
            "telephone_number": "606-599-4080",
            "fax_number": "606-712-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "375 Town Branch Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "KY",
            "postal_code": "409621326",
            "country_code": "US",
            "telephone_number": "606-598-0070",
            "fax_number": "844-273-1765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SUZANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-17",
        "last_updated": "2023-01-21",
        "certification_date": "2023-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3006246",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3006246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, KY

Sources for this page

Verify at the official NPI Registry.