Danielle Smith

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209023572 Issued in IL

Practice address

111 N 6TH St Ste G1
Pekin, IL 61554-3320

Phone

(309) 810-4407

Fax

(309) 354-2041

NPI assigned

Jul 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ensight Mental Health and Wellness PLLCGroup PAC ID 3870093982, 2 clinicians

Edgewood Clinical Services P.C.Group PAC ID 3971963901, 304 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ensight Mental Health & Wellness PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Pekin, IL
  • NPI 1841005857
  Medicare reassignment Care Compare group NPD Authorized official
• Edgewood Clinical Services, P.C.

  • Psychologist
  • Naperville, IL
  • NPI 1295914646

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Siebert Moazzam P C

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Peoria, IL
  • NPI 1396780292
  NPD
• Psychology Specialists LTD

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1053368605
  NPD (past)

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1962075382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N 6TH ST STE G1",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615543320",
            "telephone_number": "309-810-4407",
            "fax_number": "309-354-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N 6TH ST STE G1",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615543320",
            "telephone_number": "309-810-4407",
            "fax_number": "309-354-2041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209023572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Sue Simpson
• Alexandra Sinacori, LMT
• Generoso Najera Sison Jr., M.D.
• Smalltown Dental Pekin LLC
• Andrea Smith
• Elizabeth Diane Smith, RPH
• James Carl Smith, RSA DSP
• Sound Choice Hearing Clinic, Inc.
• Colleen Speten
• Michael Joseph Stanard, RSA DSP

• Psychiatric/Mental Health Nurse Practitioner in Pekin, IL
• Providers in Pekin, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.