Individual provider Active NPI

Denise Smith, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1922465897
Registry record updated May 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9168232 Issued in FL
Practice address
1824 King St
Ste 300
Jacksonville, FL 32204-4735
Phone
(904) 388-1820
Fax
(904) 388-1827
NPI assigned
Jan 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9168232 FL Primary

Addresses

Primary practice location

1824 King St
Ste 300
Jacksonville, FL 32204-4735

Mailing address

1824 King St
Ste 300
Jacksonville, FL 32204-4735
Phone (904) 388-1820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170705000867 FL Practitioner - Nurse Practitioner 2961771027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent'S Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

1824 King St
Suite 300
Jacksonville, FL 32204-4736
Phone (904) 388-1820

Hospital & facility affiliations

  • Ascension St Vincent'S Southside Hospital, Jacksonville, FL, CCN 100307
  • Ascension St Vincent'S Clay County Hospital, Middleburg, FL, CCN 100321
  • Ascension St Vincent'S Riverside Hospital, Jacksonville, FL, CCN 100040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9168232FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc CurrentSince May 8, 2017 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince May 8, 2017 Accepting new patients
Generations in Home Care Past Accepting new patients

Locations

1824 King St
Ste 300
Jacksonville, FL 32204
Phone (904) 381-9393

1658 St Vincents Way
Ste 300
Middleburg, FL 32068
Phone (904) 276-5100

1658 St Vincents Way
Ste 310
Middleburg, FL 32068
Phone (904) 308-2006

Interoperability endpoints

  • Direct secure messaging: denise.smith.1@8967.direct.athenahealth.com

Organizations & group practices 3

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 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": "1453593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1922465897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 KING ST",
            "address_2": "STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044735",
            "telephone_number": "904-388-1820",
            "fax_number": "904-388-1827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 KING ST",
            "address_2": "STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044735",
            "telephone_number": "904-388-1820",
            "fax_number": "904-388-1827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-24",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9168232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.