Individual provider Active NPI

Natausha Nacole Smith, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Kennett, MO
National Provider Identifier
1912771056
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2023043696 Issued in MO
Practice address
935 State Route VV
Kennett, MO 63857-3822
Phone
(573) 888-5925
NPI assigned
Nov 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2023043696 MO Primary

Addresses

Primary practice location

935 State Route VV
Kennett, MO 63857-3822

Mailing address

935 State Route VV
Kennett, MO 63857-3822
Phone (573) 888-5925

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
I20231207002018 MO Practitioner - Nurse Practitioner 6901255579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Counseling Center IncGroup PAC ID 2163410481, 39 clinicians

Practice addresses (Care Compare)

935 State Route VV
Kennett, MO 63857-3822
Phone (573) 888-5925

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Counseling Center, Inc. CurrentSince Oct 26, 2023 Accepting new patients
Family Counseling Center, Inc. CurrentSince Oct 26, 2023 Accepting new patients

Locations

925 State Route VV
Kennett, MO 63857
Phone (573) 359-9840

1109 Jones St
Kennett, MO 63857
Phone (573) 888-6454

3001 Warrior Ln
Poplar Bluff, MO 63901
Phone (573) 785-7453

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1912771056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 STATE ROUTE VV",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573822",
            "telephone_number": "573-888-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 STATE ROUTE VV",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573822",
            "telephone_number": "573-888-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NATAUSHA",
        "middle_name": "NACOLE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-09",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2023043696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennett, MO

Sources for this page

Verify at the official NPI Registry.