Individual provider Active NPI

Samantha Ann Smaile

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1811635675
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP142603 Issued in TX
Practice address
1101 S Main St
Fort Worth, TX 76104-4802
Phone
(817) 321-4700
Fax
(817) 850-5845
NPI assigned
May 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP142603 TX Primary

Addresses

Primary practice location

1101 S Main St
Fort Worth, TX 76104-4802

Mailing address

1101 S Main St
Fort Worth, TX 76104-4802
Phone (817) 321-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP142603TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1811635675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044802",
            "telephone_number": "817-321-4700",
            "fax_number": "817-850-5845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044802",
            "telephone_number": "817-321-4700",
            "fax_number": "817-850-5845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMAILE",
        "first_name": "SAMANTHA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.