Individual provider Active NPI

Nicole Beatrice Smith, DO

  • Emergency Medicine Physician
  • Wyoming, MI
National Provider Identifier
1841934205
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
6219 Issued in TN
Practice address
5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Phone
(616) 252-7200
Fax
(616) 252-4953
NPI assigned
Apr 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 6219 TN Primary

Addresses

Primary practice location

5900 Byron Center Ave SW
Wyoming, MI 49519-9606

Mailing address

5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-7200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250820003460 TN Practitioner - Emergency Medicine 9537549472 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of TN, PCGroup PAC ID 3173989837, 144 clinicians

Practice addresses (Care Compare)

200 Stonecrest Blvd
Smyrna, TN 37167-6810
Phone (615) 768-2500

Hospital & facility affiliations

  • Tristar Stonecrest Medical Center Hospital, Smyrna, TN, CCN 440227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
6219TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Oct 1, 2025 Accepting new patients
Emergency Medicine Services of TN, PC Emergency Medicine CurrentSince Aug 5, 2025 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

1325 Highway 76
Clarksville, TN 37043
Phone (615) 788-9324

651 Dunlop Ln
Clarksville, TN 37040
Phone (931) 502-1000

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

2300 Patterson St
Nashville, TN 37203
Phone (615) 342-1500

200 Stonecrest Blvd
Smyrna, TN 37167
Phone (615) 768-2000

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 1

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": "1650585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1841934205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-7200",
            "fax_number": "616-252-4953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-7200",
            "fax_number": "616-252-4953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICOLE",
        "middle_name": "BEATRICE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-22",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "6219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.