Individual provider Active NPI

Cynthia Jean Smith, DNP

  • Adult Health Nurse Practitioner
  • Junction City, OR
National Provider Identifier
1003036757
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
095006901N3 Issued in OR
Practice address
355 W 3Rd Ave
Junction City, OR 97448-1313
Phone
(541) 640-7625
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 095006901N3 OR Primary

Addresses

Primary practice location

355 W 3Rd Ave
Junction City, OR 97448-1313

Mailing address

1292 High St Ste 224
Eugene, OR 97401-3238
Phone (541) 500-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070910000228 OR Practitioner - Nurse Practitioner 4880787795 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icco LLCGroup PAC ID 1355406729, 133 clinicians

Practice addresses (Care Compare)

598 E 13TH Ave
Eugene, OR 97401-4783
Phone (541) 636-3473

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icco, LLC CurrentSince Nov 1, 2016 Accepting new patients
Icco, LLC Current Accepting new patients
Icco LLC CurrentSince Nov 1, 2016 Accepting new patients
Oregon Healthcare Resources, LLC CurrentSince Jan 25, 2017 Accepting new patients
Icco, LLC Past Accepting new patients

Locations

1445 Gateway Blvd
Cottage Grove, OR 97424
Phone (541) 767-3023

186 W Ellendale Ave
Dallas, OR 97338
Phone (971) 900-4984

1292 High St
Eugene, OR 97401
Phone (541) 636-3473

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

2830 Crescent Ave
Eugene, OR 97408
Phone (541) 636-9019

355 W 3rd Ave
Junction City, OR 97448
Phone (541) 998-2468

3400 Cooperative Way
Lebanon, OR 97355
Phone (541) 333-6605

2000 N 19th St
Springfield, OR 97477
Phone (541) 284-1694

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDHCAA/Endpoint/JDHCAA

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1003036757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1292 HIGH ST STE 224",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013238",
            "telephone_number": "541-500-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W 3RD AVE",
            "city": "JUNCTION CITY",
            "state": "OR",
            "postal_code": "974481313",
            "telephone_number": "541-640-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CYNTHIA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "095006901N3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Junction City, OR

Sources for this page

Verify at the official NPI Registry.