Individual provider Active NPI

Jessica L Smith, FNP-C

  • Nurse Practitioner
  • Blue Springs, MO
National Provider Identifier
1891340584
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
20190105340 Issued in MO
Practice address
3009 SW Moore St
Blue Springs, MO 64015-3309
Phone
(816) 260-0109
NPI assigned
Aug 8, 2019
Last updated
Aug 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 53-78693-091 KS
Nurse Practitioner 363L00000X 20190105340 MO Primary

Addresses

Primary practice location

3009 SW Moore St
Blue Springs, MO 64015-3309

Mailing address

408 N. 4TH St.
Suite B
Odessa, MO 64076-1646
Phone (816) 230-8777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20230811000406 MO Practitioner - Nurse Practitioner 4587026349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Odessa Medical Clinic PCGroup PAC ID 9335161819, 2 clinicians

Practice addresses (Care Compare)

408 N 4TH St
Suite B
Odessa, MO 64076-1646
Phone (816) 230-8777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-78693-091KSMDNurse Practitioner
20190105340MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Odessa Medical Clinic, PC CurrentSince Aug 7, 2023 Accepting new patients

Locations

316 W US Highway 40
Odessa, MO 64076
Phone (816) 230-8777

408 N 4th St
Ste B
Odessa, MO 64076
Phone (816) 230-8777

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 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": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1891340584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 N. 4TH ST.",
            "address_2": "SUITE B",
            "city": "ODESSA",
            "state": "MO",
            "postal_code": "640761646",
            "telephone_number": "816-230-8777",
            "fax_number": "816-230-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 SW MOORE ST",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640153309",
            "telephone_number": "816-260-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESSICA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-08",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-78693-091",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "20190105340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Springs, MO

Sources for this page

Verify at the official NPI Registry.