Individual provider Active NPI

Cecelia L Smith, N.P.

  • Adult Health Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1962588657
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
71001194 Issued in IN
Practice address
711 E 38TH St
Indianapolis, IN 46205-2748
Phone
(463) 249-2314
Fax
(317) 245-2388
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 71001194 IN Primary

Addresses

Primary practice location

711 E 38TH St
Indianapolis, IN 46205-2748

Mailing address

PO Box 746720
Atlanta, GA 30374-6720
Phone (312) 733-9730

Other identifiers 1

IdentifierTypeStateIssuer
200351900MedicaidIN

Other names 1

  • Cecelia L Cassidy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20090506000027 IN Practitioner - Nurse Practitioner 6608924428 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71001194INMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group, PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cecelia.smith@oakstreethealth.gwaydirect.com

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1962588657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746720",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746720",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 E 38TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462052748",
            "telephone_number": "463-249-2314",
            "fax_number": "317-245-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CECELIA",
        "middle_name": "L",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71001194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200351900",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CECELIA",
            "last_name": "CASSIDY",
            "middle_name": "L",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.