SAMANTHA ETHALEE SMITH APRN, FNP-BC
NPI 1134788383
Nurse Practitioner - Family in Jacksonville, FL

Q: What is Samantha Smith's NPI number?

The NPI number for Samantha Smith is 1134788383. It was assigned to this individual provider in the NPPES registry on June 11, 2019.

Q: What is Samantha Smith's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Smith was last updated on December 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 11, 2019PECOS Enrolled

10739 DEERWOOD PARK BLVD STE 200, JACKSONVILLE, FL 32256(800) 793-7050(866) 509-6155 Get Directions Write a Review

NPPES record last updated: December 18, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 18, 2024, Jun 11, 2019 (2 updates tracked since 2019).

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About Samantha Ethalee Smith Aprn, Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA ETHALEE SMITH APRN, FNP-BC (NPI 1134788383) is an individual family provider in Jacksonville, Florida, licensed in Florida (APRN11002072) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1134788383

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSAMANTHA ETHALEE SMITHCredential: APRN, FNP-BC

Location Address10739 DEERWOOD PARK BLVD STE 200Jacksonville, FL 32256-4839

Mailing Address113 Seaboard Ln Ste 200bFranklin, TN 37067-8282 · (615) 721-7024 · Fax (800) 266-5158

Phone(800) 793-7050

Fax(866) 509-6155

Sole ProprietorNo

Enumeration DateJune 11, 2019

Last NPPES UpdateDecember 18, 20242 updates tracked since enumeration

NPPES CertifiedDecember 10, 2024

✔ NPI 1134788383 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in FL · APRN11002072

10739 DEERWOOD PARK BLVD STE 200, Jacksonville, FL 32256

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Ethalee Smith Aprn, Fnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32256 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALEENA GURSKIY ARNP, FNP-BC, MSN

Nurse Practitioner (Family)