JOANN SMITH (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1407546823

JOANN SMITH (PMHNP) is a healthcare provider. based in Fairfield, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP. They hold a License No. 209-027248 (IL). The NPI Number for JOANN SMITH (PMHNP) is 1407546823

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
JOANN SMITH (PMHNP)
NPI
1407546823
Phone
(618) 842-4617
Address
213 NW 10TH ST
Enumeration Date
9 May 2023
Last Update Date
22 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2022 (4 years ago)
PAC ID
0143660357
Group Practice PAC ID
5698671741
Professional Enrollment ID
I20240503002249
Address ID
IL628371219FA213XXSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for JOANN SMITH (PMHNP)

  • 213 NW 10TH ST

    FAIRFIELD, IL 628371216

    Phone: (618) 842-4617

    Fax: (618) 300-7288

    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)

CMS reports 2 Open Payments records for all available years, with a total value of $67.

Total Amount is formed as General ($67) + Research ($0) + Ownership ($0) = $67.

Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($36).

Total Amount

$67

General + Research + Ownership

Payments

2

Total payment records

General Amount

$67

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-11

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2024-05-03

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
I20240503002249INurse PractitionerILTBD

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 62837)

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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: 5698671741View full group profile
NameSpecialtyState
Family PracticeIL
Physician AssistantIL
Family PracticeIL
Certified Registered Nurse Anesthetist (Crna)IL
Nurse PractitionerIL
-IN
Clinical Social WorkerIL
Clinical Social WorkerIL
Nurse PractitionerIL
Physician AssistantIL

Reviews

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Frequently asked questions

Is JOANN SMITH (PMHNP) listed with a National Provider Identifier?
Yes — JOANN SMITH (PMHNP) has NPI 1407546823 on file in the registry.
Is JOANN SMITH (PMHNP) still an active registrant?
JOANN SMITH (PMHNP) carries an active NPI according to the public dataset.
What area of care is associated with JOANN SMITH (PMHNP)?
JOANN SMITH (PMHNP)'s record emphasizes Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is JOANN SMITH (PMHNP) associated with Fairfield?
Public fields place JOANN SMITH (PMHNP) around Fairfield, Illinois. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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