Eda Smith, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2683 Issued in NV

Practice address

2911 N Tenaya Way Ste 105
Las Vegas, NV 89128-0488

Phone

(702) 252-8378

NPI assigned

Jan 17, 2020

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

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Caroline Kingston MD MPH Family Practice LLC

  dba Caroline Kingston MD MPH Family Prectice LLC

  • Clinic/Center
  • Santa Fe, NM
  • NPI 1194966747
  Medicare reassignment
• Ageless Men's Health NV, LLC

  • Urology Physician
  • Las Vegas, NV
  • NPI 1023330230
  NPD (past)
• Emanuel, LLC

  • In Home Supportive Care Agency
  • Santa Fe, NM
  • NPI 1073856530
  NPD (past)

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1053941005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 HAWKSDALE DR # 469",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891348967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 N TENAYA WAY STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280488",
            "telephone_number": "702-252-8378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9701 W Flamingo Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891475727",
            "country_code": "US",
            "telephone_number": "702-240-3929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-17",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destiny Smith
• Dewayne Smith Jr.
• Diamond Smith
• Dion Monique Smith
• Dominique Smith
• Elijanay Marquisha Smith
• Elisia Smith
• Elizabeth J. Smith, MSW, LSW
• Elizabeth Lee Smith
• Emella Smith

• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.