Individual provider Active NPI

Paula Fitzgerald Smith, FNP

  • Family Nurse Practitioner
  • Chandler, AZ
National Provider Identifier
1073735767
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP0814 Issued in AZ
Practice address
3960 E Riggs Rd
#1
Chandler, AZ 85249-5411
Phone
(480) 786-4441
Fax
(480) 786-4609
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN104237 AZ
Family Nurse Practitioner 363LF0000X AP0814 AZ Primary

Addresses

Primary practice location

3960 E Riggs Rd
#1
Chandler, AZ 85249-5411

Mailing address

3960 E. Riggs Rd.
#1
Chandler, AZ 85249
Phone (480) 786-4441

Other identifiers 1

IdentifierTypeStateIssuer
530148MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20031119000774 AZ Practitioner - Nurse Practitioner 0244134534 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Canyon Family Medicine PC CurrentSince Aug 22, 2012 Accepting new patients
Foot Ankle Specialty Centers, LLC PastSince Aug 22, 2012 Accepting new patients

Locations

3950 E Riggs Rd
Ste 2
Chandler, AZ 85249
Phone (480) 786-4441

3960 E Riggs Rd
Ste 1
Chandler, AZ 85249
Phone 4807864441 ext. 403

Organizations & group practices 2

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1073735767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 E. RIGGS RD.",
            "address_2": "#1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "85249",
            "telephone_number": "480-786-4441",
            "fax_number": "480-786-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 E RIGGS RD",
            "address_2": "#1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852495411",
            "telephone_number": "480-786-4441",
            "fax_number": "480-786-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PAULA",
        "middle_name": "FITZGERALD",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN104237",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP0814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "530148",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.