Samantha Ethalee Smith, APRN, FNP-BC in Jacksonville, FL

Samantha Ethalee Smith, APRN, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Jacksonville, Florida. Her current practice location is 10739 Deerwood Park Blvd Ste 200, Jacksonville, Florida. You can reach out to her office (for appointments etc.) via phone at (800) 793-7050.

Samantha Ethalee Smith is licensed to practice in Florida (license number APRN11002072) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1134788383.

Contact Information

	Samantha Ethalee Smith, APRN, FNP-BC
	10739 Deerwood Park Blvd Ste 200, Jacksonville, FL 32256-4839
	(800) 793-7050
	(866) 509-6155

Map and Direction

Provider's Profile

Full Name	Samantha Ethalee Smith
Gender	Female
Speciality	Nurse Practitioner - Family
Location	10739 Deerwood Park Blvd Ste 200, Jacksonville, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1134788383
Provider Enumeration Date: 06/11/2019
Last Update Date: 12/18/2024

Medicare PECOS Information:

PECOS PAC ID: 6800267998
Enrollment ID: I20230127002758

Medical Identifiers

Medical identifiers for Samantha Ethalee Smith such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1134788383	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	APRN11002072 (Florida)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Samantha Ethalee Smith allows following entities to bill medicare on her behalf.

Entity Name	Monogram Health Professional Services Of Florida Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1538883111 PECOS PAC ID: 0244608149 Enrollment ID: O20221128001413

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samantha Ethalee Smith is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Samantha Ethalee Smith, APRN, FNP-BC 113 Seaboard Ln Ste 200b, Franklin, TN 37067-8282 Ph: (615) 721-7024	Samantha Ethalee Smith, APRN, FNP-BC 10739 Deerwood Park Blvd Ste 200, Jacksonville, FL 32256-4839 Ph: (800) 793-7050

Reviews and Comments

Nurse Practitioner Nurses in Jacksonville, FL

Mrs. Rhode L. Jean-aleger, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 10075 Gate Pkwy N Apt 102, Jacksonville, FL 32246 Phone: 904-997-9844 Fax: 904-997-9844
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Mr. Jeffrey Ludan Vongjesda, M.S., APRN, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3728 Philips Hwy Ste 34, Jacksonville, FL 32207 Phone: 904-399-2766 Fax: 904-549-8300

Samantha Ethalee Smith, APRN, FNP-BC - Medicare Nurse Practitioner in Jacksonville, FL