NPIMap

Individual provider Active NPI

Pamela Louise Smith, PHD, FNP, RN

  • Nurse Practitioner
  • Columbia, MO
National Provider Identifier
1841806551
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
120866 Issued in MO
Practice address
1605 E Broadway Ste 100
Columbia, MO 65201-8023
Phone
(573) 815-8242
Fax
(573) 815-8245
NPI assigned
Sep 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 120866 MO Primary

Addresses

Primary practice location

1605 E Broadway Ste 100
Columbia, MO 65201-8023

Mailing address

1210 Danforth Dr
Columbia, MO 65201-6234
Phone (573) 864-5098

Other names 1

  • Dr. Pamela Louise Evans-Smith Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210211001701 MO Practitioner - Nurse Practitioner 8022423698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Columbia School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

1600 E Broadway
Columbia, MO 65201-5844
Phone (573) 815-8000

1600 E Broadway Box 50 Attn Stephanie Windsor
Columbia, MO 65201-5844

1605 E Broadway
Columbia, MO 65201-8023

1705 E Broadway
Suite 280
Columbia, MO 65201-7185
Phone (573) 815-7119

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Doctor of Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
120866MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boone Physician Services, LLC Single Specialty CurrentSince Jan 18, 2021 Accepting new patients
Mid Missouri Neurosurgery, LLP Single Specialty PastSince Sep 20, 2020 Accepting new patients

Locations

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

Interoperability endpoints

  • Direct secure messaging: pamelaevanssmith@mhccaremail.com

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1841806551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 DANFORTH DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016234",
            "telephone_number": "573-864-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 E BROADWAY STE 100",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018023",
            "telephone_number": "573-815-8242",
            "fax_number": "573-815-8245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PAMELA",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "PHD, FNP, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-17",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "120866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "EVANS-SMITH",
            "middle_name": "LOUISE",
            "prefix": "DR.",
            "credential": "PHD, FNP, RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.