Individual provider Active NPI

Angela Elaine Smith, PNP

  • Pediatric Gastroenterology Physician
  • Pensacola, FL
National Provider Identifier
1821264565
Registry record updated Apr 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
APRN9473715 Issued in FL
Practice address
8331 N Davis Hwy
Pensacola, FL 32514-6094
Phone
(850) 505-4700
Fax
(850) 505-4711
NPI assigned
May 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN9473715 FL
Pediatric Nurse Practitioner 363LP0200X 130810 MO
Pediatric Gastroenterology Physician 2080P0206X APRN9473715 FL Primary

Addresses

Primary practice location

8331 N Davis Hwy
Pensacola, FL 32514-6094

Mailing address

10140 Centurion Pkwy N
Jacksonville, FL 32256-0532
Phone (904) 697-4100

Other identifiers 1

IdentifierTypeStateIssuer
023348800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180213002574 FL Practitioner - Nurse Practitioner 9739225996 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9473715FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince Nov 1, 2017 Accepting new patients
The Nemours Foundation CurrentSince Nov 1, 2017 Accepting new patients
The Nemours Foundation Current Accepting new patients

Locations

922 Mar Walt Dr
Ste 100
Ft Walton Bch, FL 32547
Phone (850) 226-4785

10140 Centurion Pkwy N
Jacksonville, FL 32256
Phone (904) 697-4100

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

8331 N Davis Hwy
Pensacola, FL 32514
Phone (850) 505-4700

8331 N Davis Hwy
Spc Care
Pensacola, FL 32514
Phone (850) 505-4700

Interoperability endpoints

  • Direct secure messaging: asmith69853@direct.nemours.org

Organizations & group practices 3

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": "1209686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1821264565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10140 CENTURION PKWY N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560532",
            "telephone_number": "904-697-4100",
            "fax_number": "904-697-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8331 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146094",
            "telephone_number": "850-505-4700",
            "fax_number": "850-505-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANGELA",
        "middle_name": "ELAINE",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-02",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9473715",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "130810",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "FL",
            "license": "APRN9473715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023348800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.