Active NPI
Wendy J Smith, NP
- Nurse Practitioner
- Colorado Springs, CO
National Provider Identifier
1043239791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 10187
- Practice address
- 525 N Foote Ave
Suite 202
Colorado Springs, CO 80909-4501 - Phone
- (719) 365-6568
- Fax
- (719) 365-6317
- NPI assigned
- Jul 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 10187 | CO | Primary |
Addresses
Primary practice location
525 N Foote Ave
Suite 202
Colorado Springs, CO 80909-4501
Mailing address
8890 N Union Blvd
Ste 160
Colorado Springs, CO 80920-7799
Phone (719) 365-9950
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3349969 | Medicaid | TN | |
| 89327853 | Medicaid | CO | |
| 09455205 | Medicaid | MS | |
| 4103232 | Other | TN | BCBS TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10187 | CO | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boston Cancer Group, PLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba UT Cancer Institute
- Hematology & Oncology Physician
- Memphis, TN
- NPI 1710945795
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386720000000",
"number": "1043239791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8890 N UNION BLVD",
"address_2": "STE 160",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809207799",
"telephone_number": "719-365-9950",
"fax_number": "719-365-9969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 N FOOTE AVE",
"address_2": "SUITE 202",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809094501",
"telephone_number": "719-365-6568",
"fax_number": "719-365-6317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "WENDY",
"middle_name": "J",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-19",
"last_updated": "2013-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CO",
"license": "10187",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3349969",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89327853",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09455205",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS TN",
"identifier": "4103232",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.