Individual provider Active NPI

Jacqueline Nicole Smith, M.D.

  • Psychiatry Physician
  • Chapel Hill, NC
National Provider Identifier
1861528200
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Practice address
101 Manning Dr
Dept of Psychiatry, Unc Chapel Hill, CB#7160
Chapel Hill, NC 27599-7160
Phone
(919) 966-8710
Fax
(919) 966-9646
NPI assigned
Feb 27, 2007
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
Psychiatry Physician 2084P0800X NC Primary

Addresses

Primary practice location

101 Manning Dr
Dept of Psychiatry, Unc Chapel Hill, CB#7160
Chapel Hill, NC 27599-7160

Mailing address

416 Summerwalk Cir
Chapel Hill, NC 27517-8680
Phone (919) 949-0538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20070619000380 NC Practitioner - Psychiatry 3072612936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of North Carolina at Chapel Hill School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MonarchGroup PAC ID 0244273852, 92 clinicians

Practice addresses (Care Compare)

3057 Freedom Dr
Charlotte, NC 28208-3859
Phone (704) 525-3255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006-01599NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monarch CurrentSince Apr 11, 2016 Accepting new patients
Monarch Current Accepting new patients
Monarch CurrentSince Apr 11, 2016 Accepting new patients
University of North Carolina at Chapel Hill Past Accepting new patients

Locations

350 Pee Dee Ave
Ste 101
Albemarle, NC 28001
Phone (704) 986-1522

3057 Freedom Dr
Charlotte, NC 28208
Phone (704) 334-2226

820 Grimes Blvd
Lexington, NC 27292
Phone (336) 224-6071

1001 Navaho Dr
Ste 100
Raleigh, NC 27609
Phone (919) 856-4703

Organizations & group practices 4

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861528200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 SUMMERWALK CIR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275178680",
            "telephone_number": "919-949-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MANNING DR",
            "address_2": "DEPT OF PSYCHIATRY, UNC CHAPEL HILL, CB#7160",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275997160",
            "telephone_number": "919-966-8710",
            "fax_number": "919-966-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACQUELINE",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.