Individual provider Active NPI

Corrine Smith, NP

  • Gerontology Nurse Practitioner
  • Seneca, SC
National Provider Identifier
1992476923
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
29317 Issued in SC
Practice address
131 Lila Doyle Dr
Seneca, SC 29672-9495
Phone
(864) 888-3717
Fax
(864) 672-7852
NPI assigned
Sep 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2021037182 MO
Gerontology Nurse Practitioner 363LG0600X 29317 SC Primary

Addresses

Primary practice location

131 Lila Doyle Dr
Seneca, SC 29672-9495

Mailing address

300 E McBee Ave Ste 300
Greenville, SC 29601-2899
Phone (864) 522-8611

Other practice location 1

371 S Broadview St
Cape Girardeau, MO 63703-5761
Phone (573) 519-4823

Other names 1

  • Corrine Wilson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211029000642 MO Practitioner - Nurse Practitioner 5698163376 Reassigns benefits to 1 organization
I20250213000159 SC Practitioner - Nurse Practitioner 5698163376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

131 Lila Doyle Dr
Seneca, SC 29672-9495
Phone (864) 888-3717

Hospital & facility affiliations

  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078
  • Prisma Health Oconee Memorial Hospital Hospital, Seneca, SC, CCN 420009

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Dec 9, 2024 Accepting new patients
Southeast Missouri Hospital Physicians, LLC CurrentSince Mar 3, 2023 Accepting new patients
Prisma Health University Medical Group CurrentSince Dec 9, 2024 Accepting new patients

Locations

371 S Broadview St
Cape Girardeau, MO 63703
Phone (573) 331-6710

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

200 Fleetwood Dr
Ste 200
Easley, SC 29640
Phone (864) 442-8090

300 E McBee Ave
Ste 300
Greenville, SC 29601

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

3 Butternut Dr
Ste B
Greenville, SC 29605
Phone (864) 241-7272

131 Lila Doyle Dr
Seneca, SC 29672
Phone (864) 886-1911

Interoperability endpoints

  • Direct secure messaging: csmith826050@direct.ghs.myhfn.org

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 42

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1992476923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012899",
            "telephone_number": "864-522-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 LILA DOYLE DR",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296729495",
            "telephone_number": "864-888-3717",
            "fax_number": "864-672-7852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "371 S Broadview St",
            "address_purpose": "LOCATION",
            "city": "Cape Girardeau",
            "state": "MO",
            "postal_code": "637035761",
            "country_code": "US",
            "telephone_number": "573-519-4823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CORRINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2021037182",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "29317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORRINE",
            "last_name": "WILSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seneca, SC

Sources for this page

Verify at the official NPI Registry.