SHANNON JOY SMITH APRN AGPCNP-BC NPI 1750925392

NPI Information

  • NPI: 1750925392
  • Provider Name: SHANNON JOY SMITH, APRN, AGPCNP-BC
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 255 ENTERPRISE BLVD STE 101
    GREENVILLE, SC
    ZIP 29615
  • Phone: (864) 454-8120

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NPI Details

Shannon Joy Smith, APRN, AGPCNP-BC is an adult health nurse practitioner in Greenville, SC with 7 years of experience. Shannon Joy Smith, APRN, AGPCNP-BC NPI is 1750925392. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

255 ENTERPRISE BLVD STE 101
GREENVILLE, SC
ZIP 29615-530
Phone: (864) 454-8120
Fax: (864) 454-8125

The NPI 1750925392 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
  • Established patient custodial care facility, group care, or assisted living visit, typically 25 minutes (HCPCS:99335)
  • Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes (HCPCS:99336)

The enumeration date for this NPI number is 11/6/2019 and was last updated on 10/4/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse Practitioner22971SOUTH CAROLINANo
2363LA2200XNurse PractitionerAdult Health22971SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1PENDINGMEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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