Susan Irene Smith, RN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

200250149NP FNP-PP Issued in OR

Practice address

5100 SW Macadam Ave
Suite 200
Portland, OR 97239-6102

Phone

(971) 202-5500

Fax

(971) 202-5555

NPI assigned

Jun 30, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1003127515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 SW MACADAM AVE",
            "address_2": "SUITE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396102",
            "telephone_number": "971-202-5500",
            "fax_number": "971-202-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 SW MACADAM AVE",
            "address_2": "SUITE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396102",
            "telephone_number": "971-202-5500",
            "fax_number": "971-202-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SUSAN",
        "middle_name": "IRENE",
        "name_prefix": "Ms.",
        "credential": "RN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200250149NP FNP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Irene Smith
• Stephen Mark Smith, MBBS (MD EQUIVALENT)
• Susan Smith, MSW
• Susan Smith
• Susan Connie Smith, DMD, PC
• Tavis B Smith, PHARMD
• Tessa Marie Smith, DO
• Tical Lalelia Yvette Smith
• Tiffany Veronica Smith, CST
• Timothy L Smith, MD

• Family Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.