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

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: October 25, 2026.

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

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
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Samantha Smith reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pophealthcare, LLC
Same address
Nurse Practitioner
10739 DEERWOOD PARK BLVD STE 200
Jacksonville, FL 32256
  • Reassigned Medicare billing, Florida enrollment
  • 96 clinicians in this Medicare group
NPI 1164943957 (615) 721-7024
Monogram Health Professional Services Of Florida LLC
3.3 mi
Nephrology
4720 SALISBURY RD
Jacksonville, FL 32256
  • Reassigned Medicare billing, Florida enrollment
  • 98 clinicians in this Medicare group
NPI 1538883111 (615) 673-4455

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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)
10739 DEERWOOD PARK BLVD STE 200
JACKSONVILLE, FL 32256
Duval County (904) 719-7707
FLORENCE OCHIENG-KIZIA
Nurse Practitioner (Family)
10739 DEERWOOD PARK BLVD STE 200
JACKSONVILLE, FL 32256
Duval County (800) 793-7050
POPHEALTHCARE, LLC
Nurse Practitioner
10739 DEERWOOD PARK BLVD STE 200
JACKSONVILLE, FL 32256
Duval County (615) 721-7024
MS. KAYLA ANN THOMPSON FNP
Nurse Practitioner (Family)
10739 DEERWOOD PARK BLVD STE 200
JACKSONVILLE, FL 32256
Duval County (615) 721-7024
ELLEN M. HUSON ARNP, FNP
Nurse Practitioner (Family)
10739 DEERWOOD PARK BLVD STE 200
JACKSONVILLE, FL 32256
Duval County (800) 793-7050
EMCARA HEALTH LLC
Nurse Practitioner
10739 DEERWOOD PARK BLVD STE 200
JACKSONVILLE, FL 32256
Duval County (800) 793-7050
TAMARA ALICEA-NIEVES ARNP
Nurse Practitioner (Family)
10739 DEERWOOD PARK BLVD STE 200
JACKSONVILLE, FL 32256
Duval County (904) 719-7707
THERESA-LYNDA D'SOUZA AGNP-C
Nurse Practitioner
10739 DEERWOOD PARK BLVD STE 200
JACKSONVILLE, FL 32256
Duval County (954) 593-3889

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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.

Where is Samantha Smith located?

Samantha Smith practices at 10739 Deerwood Park Blvd Ste 200, Jacksonville, FL 32256. The listed phone number is (800) 793-7050.

What is Samantha Smith's specialty?

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

Is Samantha Smith enrolled in Medicare?

Yes. Samantha Smith is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Samantha Smith's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Smith reassigns Medicare benefits to 2 organizations: Pophealthcare, LLC (Jacksonville, FL) and Monogram Health Professional Services Of Florida LLC (Jacksonville, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samantha Smith's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

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 22 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.