Individual provider Active NPI

Pamela Idella Smith, RN, MSN, FNP

  • Family Nurse Practitioner
  • Bakersfield, CA
National Provider Identifier
1114221785
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP 20310 Issued in CA
Practice address
3838 San Dimas St
B-231
Bakersfield, CA 93301-2284
Phone
(661) 665-0505
Fax
(661) 665-7844
NPI assigned
Dec 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP 20310 CA Primary

Addresses

Primary practice location

3838 San Dimas St
B-231
Bakersfield, CA 93301-2284

Mailing address

4550 Califonia Ave.
Ste. 500
Bakersfield, CA 93309
Phone (661) 716-3484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20140422001530 CA Practitioner - Nurse Practitioner 6709018948 Reassigns benefits to 1 organization
Practice locations: Bakersfield, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
20310CAMDObstetrics & Gynecology Physician
NP 20310CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Infusion and Clinical Services, Inc CurrentSince Apr 1, 2023 Accepting new patients
Infusion and Clinical Services, Inc. CurrentSince Apr 1, 2023 Accepting new patients

Locations

901 Olive Dr
Bakersfield, CA 93308
Phone (661) 215-7500

5401 White Ln
Bakersfield, CA 93309
Phone (661) 396-7100

5400 Aldrin Ct
Bakersfield, CA 93313
Phone (661) 735-8867

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": "1292976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419984000000",
    "number": "1114221785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 CALIFONIA AVE.",
            "address_2": "STE. 500",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93309",
            "telephone_number": "661-716-3484",
            "fax_number": "661-716-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 SAN DIMAS ST",
            "address_2": "B-231",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933012284",
            "telephone_number": "661-665-0505",
            "fax_number": "661-665-7844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PAMELA",
        "middle_name": "IDELLA",
        "name_prefix": "Ms.",
        "credential": "RN, MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-22",
        "last_updated": "2014-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP 20310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.