Hernando Psychiatry LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

HERNANDO PSYCHIATRY LLC

Doing business as

Hernando Psychiatry

Practice address

324 W Valley St Ste 108
Hernando, MS 38632-1749

Phone

(901) 491-0130

NPI assigned

Mar 22, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Ethan Tyler Smitherman, PMHNPNPI 1316643398

Title

Owner

Phone

(901) 491-0130

Specialties & licenses 2

Addresses

Other names 1

• Hernando Psychiatry Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ethan Tyler Smitherman, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Hernando, MS
  • NPI 1316643398
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679443200000",
    "number": "1912600750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 W VALLEY ST STE 108",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386321749",
            "telephone_number": "901-491-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W VALLEY ST STE 108",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386321749",
            "telephone_number": "901-491-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERNANDO PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A",
        "authorized_official_last_name": "SMITHERMAN",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_middle_name": "TYLER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-491-0130",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hernando Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Henderson Vision Center
• Kenya Henderson, OD
• Henry Health & Wellness, LLC
• Hernando Dental Group Incorporated
• Hernando Family Chiropractic, LLC
• Hunter Hill
• William Hill
• Jacqueline Hodges, RDN
• Julie Johnston Holcomb, LCSW
• Karen D Holley

• Psychiatric/Mental Health Nurse Practitioner in Hernando, MS
• Providers in Hernando, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.