BETHANY P. SMITH (NPI# 1821540790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821540790 |
| Entity Type | Individual |
| Full Name | BETHANY P. SMITH |
| Credential | PA-C |
| Practice Address |
1075 Mason Ave Daytona Beach FL 32117 |
| Mailing Address |
1075 Mason Ave Daytona Beach FL 32117-4611 |
| Practice Telephone | 3862554596 |
| Practice Fax Number | 3862583561 |
| Mailing Telephone | 3862554596 |
| Mailing Fax Number | 3862583561 |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2019-08-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9109967 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 100680300 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1165 Dunlawton Ave Ste 102, Port Orange, FL 321272924 | 3862554596 | 3862583561 |
| 1175 Dunlawton Ave Ste 1, Port Orange, FL 321274741 | 3862554596 | 3862583561 |
| 17 Old Kings Rd N Ste K, Palm Coast, FL 321378283 | 3862554596 | 3862583561 |
| 1890 Lpga Blvd Ste 240, Daytona Beach, FL 321177131 | 3862554596 | 3862583561 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689235277 | Bethany Smith | Hearing Instrument Specialist | 6103 Carlisle Pike Frnt Suite, Mechanicsburg, PA 17050-2326 | 2019-06-25 |
| 1538350152 | Bethany Anne Smith | Specialist | 213 Ross Hill Rd, Conklin, NY 13748-1706 | 2007-08-08 |
| 1326673633 | Bethany Smith | Nurse Practitioner | 2510 El Camino Real, Carlsbad, CA 92008-1273 | 2020-03-06 |
| 1053942235 | Bethany Pond Smith | Nurse Practitioner | 16 Hyland Rd, Greenville, SC 29615-5756 | 2020-01-28 |
| 1477195543 | Bethany Grace Smith | Developmental Therapist | 260 S. Marion Avenue, Building A, Suite 135, Lake City, FL 32025 | 2019-10-10 |
| 1073033320 | Bethany Rena Smith | Registered Nurse | 13020 Meridian Ave S, Everett, WA 98208 | 2017-06-27 |
| 1528506185 | Bethany Ann Smith | Registered Nurse | 1026 A Ave Ne, Attn: 3 Center, Cedar Rapids, IA 52402-5036 | 2017-02-03 |
| 1548704463 | Bethany Lasky Smith | Nurse Practitioner | 490 Bill Kennedy Way Se, Atlanta, GA 30316-6835 | 2016-12-12 |
| 1255792792 | Bethany Melva Smith | Physician Assistant | 2405 N Columbus St, Suite 250, Lancaster, OH 43130-8185 | 2016-03-11 |
| 1801291448 | Bethany Pearl Smith | Physical Therapist | 120 Irmc Dr, Suite 160, Indiana, PA 15701-3674 | 2014-10-24 |
| Street Address |
1075 MASON AVE |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710966601 | Albert W. Gillespy | Orthopaedic Surgery | 1075 Mason Ave, Daytona Beach, FL 32117 | 2006-01-10 |
| 1578160099 | Susan Kinsey | Physician Assistant | 1075 Mason Ave, Daytona Beach, FL 32117-4690 | 2020-10-07 |
| 1659988996 | Jonathan David Hodge | Physical Therapist | 1075 Mason Ave, Daytona Beach, FL 32117-4611 | 2020-09-30 |
| 1851854103 | Lindsey Watson | Nurse Practitioner | 1075 Mason Ave, Daytona Beach, FL 32117-4611 | 2019-04-12 |
| 1578032561 | Alberto M. Garcia | Physical Therapist | 1075 Mason Ave, Daytona Beach, FL 32117 | 2018-11-19 |
| 1083123509 | Maxx Allen Ramirez | Physician Assistant | 1075 Mason Ave, Daytona Beach, FL 32117-4611 | 2017-09-27 |
| 1699145375 | Jeffrey C. Moore | Physical Therapist | 1075 Mason Ave, Daytona Beach, FL 32117-4611 | 2015-10-06 |
| 1225436587 | Elton Gene Miranda | Nurse Practitioner | 1075 Mason Ave, Daytona Beach, FL 32117-4611 | 2014-12-18 |
| 1184031338 | Daniel Scott Winecoff | Nurse Practitioner | 1075 Mason Ave, Daytona Beach, FL 32117-4611 | 2014-07-21 |
| 1841618782 | Richard C. Sims | Pain Medicine | 1075 Mason Ave, Daytona Beach, FL 32117-4611 | 2014-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992350409 | Erin Selfridge | Pharmacist | 1500 Beville Rd #300, Daytona Beach, FL 32117 | 2019-08-02 |
| 1881185494 | Wellspring Health, LLC | Chiropractor | 701 Ridgewood Ave, Holly Hills, FL 32117 | 2018-05-21 |
| 1780172791 | L & L Db, LLC | Clinic/Center | 1540 Cornerstone Blvd, Suite 100, Daytona Beach, FL 32117 | 2018-04-25 |
| 1154837789 | Brittany Nikolow | Nurse Practitioner | 1717 N. Clyde Morris, Daytona Beach, FL 32117 | 2017-12-19 |
| 1205356946 | Alejandro Andre Pabon Rodriguez | Nurse Anesthetist, Certified Registered | Florida Hospital Memorial Medical Center, 301 Memorial Medical Parkway, Daytona Beach, FL 32117 | 2017-06-23 |
| 1316492135 | Ann Van Herck | Physical Therapist | 1901 Mason Ave Ste 105, Daytona Beach, FL 32117 | 2016-08-22 |
| 1952784779 | Kathryn Brenna Copley | Nurse Practitioner | 1890 Lpga Blvd., Daytona Beach, FL 32117 | 2015-06-30 |
| 1053719559 | Alicia Graham | Case Manager/Care Coordinator | 1570 Megan Bay Circle, Holly Hill, FL 32117 | 2014-12-15 |
| 1578974440 | Halifax Senior Care Inc | Clinic/Center | 1515 Ridgewood Ave, Suite B, Holly Hill, FL 32117 | 2014-05-14 |
| 1013345883 | Kist Alf, Inc | Assisted Living Facility | 1516 Carmen Avenue, Daytona Beach, FL 32117 | 2013-10-14 |
| Find all providers in zip 32117 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1013568856 | Priya Phiroze Desai | Physician Assistant | 301 Memorial Medical Pkwy Ste 307, Daytona Beach, FL 32117-5167 | 2019-09-23 |
| 1104297829 | Adrianne Newton | Physician Assistant | 303 S. Clyde Morris Blvd., Daytona Beach, FL 32114 | 2015-10-08 |
| 1841668068 | Colleen L Ursic | Physician Assistant | 655 N Clyde Morris Blvd Ste B, Daytona Beach, FL 32114-2321 | 2015-09-03 |
| 1225341191 | Kristin Wunker Nelson | Physician Assistant | 1890 Lpga Blvd Ste 250, Daytona Beach, FL 32117-7131 | 2010-07-21 |
| 1093924136 | Andrew George Giaconi | Physician Assistant | 1040 Mason Ave, Daytona Beach, FL 32117-4612 | 2007-05-22 |
| 1851506760 | Cindy R Parker | Physician Assistant | 1367 Beville Rd, Daytona Beach, FL 32119-1529 | 2007-05-14 |
| 1750323978 | David J Jones | Physician Assistant | 721 S Beach St Apt 214a, Daytona Beach, FL 32114-5404 | 2006-06-12 |
| 1073568747 | Anthony A. Azzarello | Physician Assistant | 303 No. Clyde Morris Blvd., Halifax Medical Center - Chest Pain Center, Daytona Beach, FL 32114-2709 | 2006-05-23 |
| 1336193044 | Kandace F Vagovic | Physician Assistant | 517 Health Blvd, Daytona Beach, FL 32114-1493 | 2006-05-19 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32117 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.