Individual provider Active NPI

Lea Purisima Smith, RN

  • Registered Nurse
  • Newport, OR
National Provider Identifier
1083066526
Registry record updated Sep 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
201605283RN Issued in OR
Practice address
1010 SW Coast Hwy
Suite 203
Newport, OR 97365-5288
Phone
(541) 265-4947
Fax
(541) 574-7670
NPI assigned
Jul 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201605283RN OR Primary

Addresses

Primary practice location

1010 SW Coast Hwy
Suite 203
Newport, OR 97365-5288

Mailing address

1510 SE Sturdevant Rd
Toledo, OR 97391-2125
Phone (541) 265-0581

Other identifiers 1

IdentifierTypeStateIssuer
201605283RNOtherORRN-OREGON

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
201605283RNORMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475107200000",
    "number": "1083066526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 SE STURDEVANT RD",
            "city": "TOLEDO",
            "state": "OR",
            "postal_code": "973912125",
            "telephone_number": "541-265-0581",
            "fax_number": "541-574-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SW COAST HWY",
            "address_2": "SUITE 203",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973655288",
            "telephone_number": "541-265-4947",
            "fax_number": "541-574-7670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LEA",
        "middle_name": "PURISIMA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-08",
        "last_updated": "2016-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201605283RN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN-OREGON",
            "identifier": "201605283RN",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; 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.