Individual provider Active NPI

Samantha Smith, FNP

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1033535406
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95000422 Issued in CA
Practice address
150 N Reno St
Los Angeles, CA 90026-4656
Phone
(213) 380-7298
Fax
(213) 385-1123
NPI assigned
Mar 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95000422 CA Primary

Addresses

Primary practice location

150 N Reno St
Los Angeles, CA 90026-4656

Mailing address

950 S Grand Ave FL 2
Los Angeles, CA 90015-3999
Phone (323) 669-4346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160128000341 CA Practitioner - Nurse Practitioner 3173826914 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95000422CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johns Community Health Current Accepting new patients
St. Johns Community Health CurrentSince Dec 21, 2015 Accepting new patients
St. Johns Community Health CurrentSince Dec 21, 2015 Accepting new patients
Cedars-Sinai Medical Care Foundation Past Accepting new patients

Locations

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

2512 Alta St
Los Angeles, CA 90031
Phone (323) 441-2139

Interoperability endpoints

  • Direct secure messaging: ssmith191762@direct.ochin.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1033535406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 S GRAND AVE FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153999",
            "telephone_number": "323-669-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N RENO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900264656",
            "telephone_number": "213-380-7298",
            "fax_number": "213-385-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SAMANTHA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-10",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.