Individual provider Active NPI

Mary Sylvia Smith, FNP-C

  • Family Nurse Practitioner
  • Flagstaff, AZ
National Provider Identifier
1093602633
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F06250240 Issued in AZ
Practice address
1001 N 4TH St Apt 3-101
Flagstaff, AZ 86004-7826
Phone
(928) 310-2309
NPI assigned
Jun 18, 2025
Last updated
Jun 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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 F06250240 AZ Primary
Family Nurse Practitioner 363LF0000X RNP325509 AZ

Addresses

Primary practice location

1001 N 4TH St Apt 3-101
Flagstaff, AZ 86004-7826

Mailing address

1001 N 4TH St Apt 3-101
Flagstaff, AZ 86004-7826
Phone (928) 310-2309

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
I20250903001761 AZ Practitioner - Nurse Practitioner 2264933944 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Wound Solutions LLCGroup PAC ID 3072954759, 23 clinicians
Native Americans for Community Action IncGroup PAC ID 5597740464, 11 clinicians

Practice addresses (Care Compare)

10210 N 92ND St
Suite 104
Scottsdale, AZ 85258-4531
Phone (480) 493-0900

1500 E Cedar Ave
Suite 26
Flagstaff, AZ 86004-1642
Phone (928) 773-1245

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F06250240AZMDFamily Nurse Practitioner
RNP325509AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Native Americans for Community Action, Inc CurrentSince Jul 1, 2025 Accepting new patients
Innovative Wound Solutions, LLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

1500 E Cedar Ave
Ste 26
Flagstaff, AZ 86004
Phone (928) 773-1245

1500 E Cedar Ave
Ste 56
Flagstaff, AZ 86004
Phone (928) 526-2968

10210 N 92nd St
Ste 104
Scottsdale, AZ 85258
Phone (480) 493-0900

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: mary.smith.1@31166.direct.athenahealth.com
  • Direct secure messaging: mary.smith.p1@direct.nacainc.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1750204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1093602633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N 4TH ST APT 3-101",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860047826",
            "telephone_number": "928-310-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N 4TH ST APT 3-101",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860047826",
            "telephone_number": "928-310-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARY",
        "middle_name": "SYLVIA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-18",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "F06250240",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RNP325509",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.