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Debra Warren Smothers

Physician β€’ Middleburg, FL

Active NPI 1801637509 Individual Practitioner Female Practitioner
Practice location in NPPES

3872 Trail Ridge Rd
Middleburg, FL 320689028

Call 9043070071 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

3872 Trail Ridge Rd

Middleburg, FL 320689028

Telephone 9043070071
Organization at the Same NPPES Address or Phone
Divine Purpose Llc Facility NPI 1962225995

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2024

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-11-01
Ambulance - Land Transport Primary Specialty

NUCC Taxonomy Code: 3416L0300X

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
πŸ“
Updated Business Mailing Address November 01, 2024

Registered at 1075 OAKLEAF PLANTATION PKWY, STE 304, #181, ORANGE PARK, FL 32065 (Tel: 9046896854)

βœ…
NPI Profile Active June 05, 2024

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) June 05, 2024

Registered at 3872 TRAIL RIDGE RD, MIDDLEBURG, FL 320689028 (Tel: 9043070071)

πŸ“
Business Mailing Address (Initial Record) June 05, 2024

Registered at 3872 TRAIL RIDGE RD, MIDDLEBURG, FL 320689028 (Tel: 9043070071)

πŸ‘€
Provider Name / Credentials (Initial Record) June 05, 2024

Recorded as DEBRA SMOTHERS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 05, 2024

Ambulance

🟒
Initial NPI Registration & Enumeration June 05, 2024

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1801637509
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 05, 2024
Last Update: November 01, 2024
Sole Proprietor: Yes

Mailing Address

1075 Oakleaf Plantation Pkwy, Ste 304, #181

Orange Park, FL 32065

Phone: 9046896854

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.