Individual provider Active NPI

Christine Sue Smith, ARNP

  • Nurse Practitioner
  • Punta Gorda, FL
National Provider Identifier
1841308046
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2014412 Issued in FL
Practice address
29199 Livingston Dr
Punta Gorda, FL 33982-1212
Phone
(941) 235-2710
Fax
(941) 235-2712
NPI assigned
Aug 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2014412 FL Primary

Addresses

Primary practice location

29199 Livingston Dr
Punta Gorda, FL 33982-1212

Mailing address

29199 Livingston Dr
Punta Gorda, FL 33982-1212
Phone (941) 235-2710

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
I20130612000638 FL Order and Referring Only - Nurse Practitioner 9335388818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2014412FLMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841308046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29199 LIVINGSTON DR",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339821212",
            "telephone_number": "941-235-2710",
            "fax_number": "941-235-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29199 LIVINGSTON DR",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339821212",
            "telephone_number": "941-235-2710",
            "fax_number": "941-235-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHRISTINE",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "2014412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Punta Gorda, FL

Sources for this page

Verify at the official NPI Registry.