SANDRA SMITH – Primary Care Nurse Practitioner, NPI 1013319367

SANDRA SMITH is a healthcare provider. based in Madison, Indiana. specializing in Primary Care Nurse Practitioner. They hold a License No. 363LP2300X (IN). The NPI Number for SANDRA SMITH is 1013319367

Main info

Female
Sole Proprietor
12 Years Of Experience
Accepts Medicare Assignment
Name
SANDRA SMITH
NPI
1013319367
Phone
(812) 274-0713
Address
220 CLIFTY DR STE J
Enumeration Date
18 September 2014
Last Update Date
9 June 2022

Doctor Profile

Medical School Name
INDIANA MEDICAL COLLEGE, SCHOOL OF MEDICINE OF PURDUE UNIVERSITY
Secondary Phone
8122652611
Graduation Year
2014 (12 years ago)
PAC ID
7719283886
Group Practice PAC ID
1759280118
Professional Enrollment ID
I20160316000479
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:11State licenses:1Digital endpointsOther names

Provider Addresses for SANDRA SMITH

  • 220 CLIFTY DR STE J

    MADISON, IN 472501669

    Phone: (812) 274-0713

    Fax: (812) 205-2970

    Type: Mailing

  • 925 MALLORY PKWY

    FRANKLIN, IN 461317734

    Phone: (317) 560-7478

    Type: Mailing

  • 2329 NORTH MARR ROAD

    WOW CLINIC

    COLUMBUS, IN 47203

    Phone: (812) 578-4511

    Type: Location

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 $35.

Total Amount is formed as General ($35) + Research ($0) + Ownership ($0) = $35.

Last reported payment date: 2023-07-21 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($35).

Total Amount

$35

General + Research + Ownership

Payments

2

Total payment records

General Amount

$35

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-07-21

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: 2016-03-16

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
I20160316000479INurse PractitionerINTBD

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 47250)

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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: 1759280118View full group profile
NameSpecialtyState
Nurse PractitionerME
Psychiatry, Geriatric PsychiatryIN
-IN
Nurse PractitionerIN
P S Y C H I A T R YIN
-IN
-OH
Nurse PractitionerKY
Nurse PractitionerIN
Psychiatry, Geriatric PsychiatryIN

Reviews

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Frequently asked questions

What is the registry number for SANDRA SMITH?
The registry entry for SANDRA SMITH shows NPI 1013319367.
Should I treat SANDRA SMITH as an active provider?
Patients and plans typically see SANDRA SMITH as active in the national extract.
What type of care does SANDRA SMITH provide?
SANDRA SMITH's profile centers on Primary Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Which community is linked to SANDRA SMITH?
SANDRA SMITH shows a connection to Madison, Indiana in registry-derived data.
Why is information missing for SANDRA SMITH?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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