Individual provider Active NPI

Tray Bennett Nesmith, NP

  • Acute Care Nurse Practitioner
  • Arab, AL
National Provider Identifier
1871933986
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-108707 Issued in AL
Practice address
131 Golfview Dr NE
Arab, AL 35016-5473
Phone
(256) 640-8416
Fax
(256) 640-8450
NPI assigned
Jul 3, 2013
Last updated
Jan 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-108707 AL Primary

Addresses

Primary practice location

131 Golfview Dr NE
Arab, AL 35016-5473

Mailing address

PO Box 131
Arab, AL 35016-0131
Phone (256) 640-8416

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20131122001206 AL Practitioner - Nurse Practitioner 8527294461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marshall Primary Care LLCGroup PAC ID 5395159388, 2 clinicians

Practice addresses (Care Compare)

131 Golfview Dr NE
Arab, AL 35016-5473
Phone (256) 640-8416

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall Primary Care LLC CurrentSince Oct 29, 2020 Accepting new patients

Locations

131 Golfview Dr NE
Arab, AL 35016
Phone (256) 640-8416

Interoperability endpoints

  • Direct secure messaging: office@marshallprimarycarellc.kareodirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1871933986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 131",
            "city": "ARAB",
            "state": "AL",
            "postal_code": "350160131",
            "telephone_number": "256-640-8416",
            "fax_number": "256-640-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 GOLFVIEW DR NE",
            "city": "ARAB",
            "state": "AL",
            "postal_code": "350165473",
            "telephone_number": "256-640-8416",
            "fax_number": "256-640-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESMITH",
        "first_name": "TRAY",
        "middle_name": "BENNETT",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-03",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-108707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arab, AL

Sources for this page

Verify at the official NPI Registry.