TYNEAL SMITH (FNP) – Nurse Practitioner, NPI 1174402846

TYNEAL SMITH (FNP) is a healthcare provider. based in Pensacola, Florida. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 11041917 (FL). The NPI Number for TYNEAL SMITH (FNP) is 1174402846

Main info

Female
Sole Proprietor
1 Year Of Experience
Accepts Medicare Assignment
Name
TYNEAL SMITH (FNP)
NPI
1174402846
Phone
Not provided
Address
1555 N PALAFOX ST
Enumeration Date
28 August 2025
Last Update Date
3 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8505123482
Graduation Year
2025 (1 year ago)
PAC ID
0345746194
Group Practice PAC ID
8426324369
Professional Enrollment ID
I20251001001670
Address ID
FL325012134PE1555XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

24,232 NURSE PRACTITIONER in FL

Provider Addresses for TYNEAL SMITH (FNP)

  • 1555 N PALAFOX ST

    PENSACOLA, FL 325012134

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-10-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251001001670INurse PractitionerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32501)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8426324369View full group profile
NameSpecialtyState
N E U R O S U R G E R YFL
Physician AssistantFL
Orthopedic SurgeryFL

Reviews

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Frequently asked questions

Can I verify TYNEAL SMITH (FNP) with an NPI only?
You can start verification with NPI 1174402846 for TYNEAL SMITH (FNP), then check state licensing separately.
Does the file indicate TYNEAL SMITH (FNP) is practicing under active NPI?
Directory data currently reports TYNEAL SMITH (FNP) as active.
What is TYNEAL SMITH (FNP)'s primary classification?
Nurse Practitioner is the headline specialty for TYNEAL SMITH (FNP) here. Clinical services aligned with this taxonomy classification.
What area does TYNEAL SMITH (FNP) serve?
TYNEAL SMITH (FNP)'s listing highlights Pensacola, Florida; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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