Individual provider Active NPI

Nastassia Smith, FNP

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1861965667
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
25258 Issued in TN
Practice address
3109 Walnut Grove Rd
Memphis, TN 38111-3509
Phone
(901) 515-4800
Fax
(901) 458-0388
NPI assigned
Jan 4, 2019
Last updated
Jan 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 25258 TN Primary

Addresses

Primary practice location

3109 Walnut Grove Rd
Memphis, TN 38111-3509

Mailing address

877 Jefferson Ave
Memphis, TN 38103-2807
Phone (901) 545-8336

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190318001414 TN Practitioner - Nurse Practitioner 4688914252 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curana Health of Tennessee LLCGroup PAC ID 7416261482, 56 clinicians
B M Physicians, LLCGroup PAC ID 1951583939, 5 clinicians

Practice addresses (Care Compare)

5865 Ridgeway Ctr Pkwy
Memphis, TN 38120-4032
Phone (337) 991-9276

943 Whitney Ave
Memphis, TN 38127-7734
Phone (901) 358-0326

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25258TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Little Clinic of Tennessee LLC Family CurrentSince Apr 24, 2021 Accepting new patients
Curana Health of Tennessee LLC Family CurrentSince Mar 7, 2022 Accepting new patients
Frayser Medical Center Inc. Current Accepting new patients

Locations

5865 Ridgeway Center Pkwy
Memphis, TN 38120
Phone (901) 219-1295

2449 Old Fort Pkwy
Murfreesboro, TN 37128
Phone (615) 225-0140

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1861965667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032807",
            "telephone_number": "901-545-8336",
            "fax_number": "901-545-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 WALNUT GROVE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381113509",
            "telephone_number": "901-515-4800",
            "fax_number": "901-458-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NASTASSIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-04",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "25258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.