Individual provider Active NPI

Brandon M Smith, RN, MSN, APRN-BC

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Edwards, CO
National Provider Identifier
1912108648
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
0996112 Issued in CO
Practice address
439 Edwards Access Rd
Edwards, CO 81632-5634
Phone
(970) 445-2489
Fax
(970) 470-6510
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X R1612293 MN
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X R161229-3 MN
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 0996112 CO Primary

Addresses

Primary practice location

439 Edwards Access Rd
Edwards, CO 81632-5634

Mailing address

PO Box 4330
Avon, CO 81620-4330
Phone (970) 926-6340

Other practice location 1

1406 6th Avenue North
St. Cloud Hospital
St. Cloud, MN 56303
Phone (320) 251-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090717000285 MN Practitioner - Certified Clinical Nurse Specialist (CNS) 8628120938 Reassigns benefits to 4 organizations
I20210428000581 CO Practitioner - Nurse Practitioner 8628120938

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Cloud HospitalGroup PAC ID 4880594779, 215 clinicians

Practice addresses (Care Compare)

110 2ND St S
Suite 104
Waite Park, MN 56387-1367
Phone (320) 259-9375

1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
0996112COMDAdult Psychiatric/Mental Health Clinical Nurse Specialist
R161229-3MNMDAdult Psychiatric/Mental Health Clinical Nurse Specialist
R1612293MNMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health System - Melrose CurrentSince Jan 18, 2017 Accepting new patients
St. Cloud Hospital CurrentSince Jul 20, 2009 Accepting new patients
St. Cloud Hospital Current Accepting new patients
Centracare Health System - Melrose CurrentSince Jan 18, 2017 Accepting new patients
Centracare Health System-NR LLC CurrentSince Sep 5, 2018 Accepting new patients
St. Cloud Hospital CurrentSince Jul 20, 2009 Accepting new patients
Centracare Health System-NR LLC CurrentSince Sep 5, 2018 Accepting new patients
Colorado Mountain Medical, LLC PastSince Sep 8, 2019 Accepting new patients
St. Cloud Hospital Past Accepting new patients

Locations

525 Main St W
Melrose, MN 56352
Phone (320) 256-4228

1013 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2303

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

1900 Centracare Cir
Ste 2475
Saint Cloud, MN 56303
Phone (320) 229-4977

110 2nd St S
Ste 104
Waite Park, MN 56387
Phone (320) 259-9375

Interoperability endpoints

  • Direct secure messaging: bsmith12161@direct.centracare.com

Organizations & group practices 9

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 6

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1912108648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4330",
            "city": "AVON",
            "state": "CO",
            "postal_code": "816204330",
            "telephone_number": "970-926-6340",
            "fax_number": "970-926-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 EDWARDS ACCESS RD",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816325634",
            "telephone_number": "970-445-2489",
            "fax_number": "970-470-6510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1406 6th Avenue North",
            "address_2": "St. Cloud Hospital",
            "address_purpose": "LOCATION",
            "city": "St. Cloud",
            "state": "MN",
            "postal_code": "56303",
            "country_code": "US",
            "telephone_number": "320-251-2700",
            "fax_number": "320-229-5109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRANDON",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "RN, MSN, APRN-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MN",
            "license": "R1612293",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MN",
            "license": "R161229-3",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "CO",
            "license": "0996112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwards, CO

Sources for this page

Verify at the official NPI Registry.