STEPHANIE DORA SMITH (NP) – Gerontology Nurse Practitioner, NPI 1417208463

STEPHANIE DORA SMITH (NP) is a healthcare provider. based in Grand rapids, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 4704272685 (MI). The NPI Number for STEPHANIE DORA SMITH (NP) is 1417208463

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
STEPHANIE DORA SMITH (NP)
NPI
1417208463
Phone
(616) 685-3330
Address
245 CHERRY ST SE
Enumeration Date
29 September 2012
Last Update Date
29 January 2025

Doctor Profile

Medical School Name
VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6163915600
Graduation Year
2012 (14 years ago)
PAC ID
8628220092
Group Practice PAC ID
4587568647
Professional Enrollment ID
I20140915002331
Address ID
MI495084600KE4444XSEXX401
Telehealth
Yes

Contacts

Secure Messaging
ssmith257837@epic00.shdirect.org
FHIR Endpoint
https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness85
Years active:13State licenses:1Other namesUpdated within 12 months

8,105 NURSE PRACTITIONER in MI

Provider Addresses for STEPHANIE DORA SMITH (NP)

  • 245 CHERRY ST SE

    SUITE 204

    GRAND RAPIDS, MI 495034607

    Phone: (616) 685-3330

    Type: Mailing

  • 100 MICHIGAN ST NE # MC845

    GRAND RAPIDS, MI 495032560

    Phone:

    Type: Mailing

  • 275 MICHIGAN ST NE

    GRAND RAPIDS, MI 495032531

    Phone: (616) 267-7104

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $127.

Total Amount is formed as General ($127) + Research ($0) + Ownership ($0) = $127.

Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Abbott Laboratories ($127).

Total Amount

$127

General + Research + Ownership

Payments

1

Total payment records

General Amount

$127

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-16

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Abbott Laboratories$127
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: 2014-09-15

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
I20140915002331INurse PractitionerMITBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99350Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes3523$0
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes2412$0
View full utilization report →

Insurance plans in this area (ZIP 49503)

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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: 4587568647View full group profile
NameSpecialtyState
Critical Care (Intensivists)IL
Physician AssistantMI
Physician AssistantMI
Physician AssistantMI
-MI
Vascular SurgeryIL
-MI
-MI
A N E S T H E S I O L O G YTX
Clinical Social WorkerMI

Reviews

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Frequently asked questions

Does STEPHANIE DORA SMITH (NP) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — STEPHANIE DORA SMITH (NP) uses 1417208463.
Does CMS list STEPHANIE DORA SMITH (NP) as active?
Yes — STEPHANIE DORA SMITH (NP) is active in the NPI listing used on this page.
What is STEPHANIE DORA SMITH (NP)'s primary classification?
Gerontology Nurse Practitioner is the headline specialty for STEPHANIE DORA SMITH (NP) here. Clinical services aligned with this taxonomy classification.
What address line appears for STEPHANIE DORA SMITH (NP)?
STEPHANIE DORA SMITH (NP)'s geographic hint is Grand Rapids, Michigan in our summary view.
Why does STEPHANIE DORA SMITH (NP) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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