Carolyn Ann Smith, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA14769 Issued in CA

Practice address

1551 Bishop St
220
San Luis Obispo, CA 93401-4635

Phone

(805) 541-0668

Fax

(805) 541-8213

NPI assigned

May 30, 2007

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

Not listed in the public Medicare enrollment file

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.

• J. Robert West, M.D., Inc

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  • Irvine, CA
  • NPI 1295917904
  NPD (past)

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1114128956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E REDLANDS BLVD",
            "address_2": "212",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734775",
            "telephone_number": "909-335-8649",
            "fax_number": "909-335-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 BISHOP ST",
            "address_2": "220",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014635",
            "telephone_number": "805-541-0668",
            "fax_number": "805-541-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CAROLYN",
        "middle_name": "ANN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA14769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randy D Smart Jr., ABOC, NCLEC, RDO
• Julie N Smelser, M.D.
• Cindi Smith-Dunham, PHARMD
• Aiden Smith
• Bryan A Smith
• Colie Smith
• Drielle Smith
• Evelyn Renee Smith, M.D.
• Hannah Smith
• Jaylynn Ann Smith

• Medical Physician Assistant in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.