Caroline O Smith, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9106283 Issued in FL

Practice address

1670 St Vincents Way
Middleburg, FL 32068-8447

Phone

(904) 602-1400

NPI assigned

Dec 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Emergency Medical Specialists of Jacksonville

  • Emergency Medicine Physician
  • Jacksonville, FL
  • NPI 1295738367
  Medicare reassignment
• Emergency Physicians Inc

  • Emergency Medicine Physician
  • Jacksonville, FL
  • NPI 1285686675
  Medicare reassignment
• Emergency Physicians Inc

  • Emergency Medicine Physician
  • Brunswick, GA
  • NPI 1477001972
  NPD
• Kingsley Avenue Emergency Physicians LLC

  • Emergency Medicine Physician
  • Orange Park, FL
  • NPI 1679915300
  NPD (past)
• CT Emergency Medicine Specialists, LLC

  • Emergency Medicine Physician
  • Bristol, CT
  • NPI 1699892208
  NPD (past)

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1972786903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 E TEAGUE BAY DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923093",
            "telephone_number": "203-572-2439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 ST VINCENTS WAY",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688447",
            "telephone_number": "904-602-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CAROLINE",
        "middle_name": "O",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "002022",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohini B Shukla, MD
• Steven Siegel, MD
• Lydia Sierra, LPN
• Teofilo Obina Sim III, PT
• Skage Transport LLC
• Susan Marie Smith, LDO
• Debra Warren Smothers
• Solantic of Jacksonville, LLC
• Monika Sood, PA-C
• South Clay Medical Associates Inc

• Physician Assistant in Middleburg, FL
• Providers in Middleburg, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.