NPIMap

Individual provider Active NPI

Smitha John, APN-CNP

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1184166613
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209015011 Issued in IL
Practice address
1950 W Polk St
Chicago, IL 60612-3723
Phone
(312) 864-0726
Fax
(312) 864-9734
NPI assigned
Nov 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209015011 IL Primary

Addresses

Primary practice location

1950 W Polk St
Chicago, IL 60612-3723

Mailing address

1950 W Polk St
Chicago, IL 60612-3723
Phone (312) 864-6445

Other practice location 1

9977 Woods Dr Fl 1
Skokie, IL 60077
Phone (224) 364-2273

Other practice location 2

880 W Central Rd Ste 3800
Arlington Hts, IL 60005-2369
Phone (847) 255-0900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smitha.john@direct.ccprovider.org Direct Cook County

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190226003479 IL Practitioner - Nurse Practitioner 6103165741 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook CountyGroup PAC ID 2860398088, 770 clinicians

Practice addresses (Care Compare)

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 633-7292

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
74.7
Promoting interoperability
100
Improvement activities
40
Cost
85.45

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Current Accepting new patients
Cook County CurrentSince Jan 23, 2020 Accepting new patients
Cook County Current Accepting new patients
Cook County CurrentSince Jan 23, 2020 Accepting new patients
Endeavor Health Medical Group CurrentSince Feb 6, 2019 Accepting new patients
Endeavor Health Clinical Operations Past Accepting new patients
John H Stroger Jr Hospital Cook County Past Accepting new patients

Locations

880 W Central Rd
Ste 3800
Arlington Hts, IL 60005
Phone (847) 255-0900

12757 Western Ave
Blue Island, IL 60406
Phone (708) 293-8400

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

9977 Woods Dr
Fl 1
Skokie, IL 60077
Phone (847) 663-8350

Interoperability endpoints

  • Direct secure messaging: smitha.john@direct.ccprovider.org

Organizations & group practices 7

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.

Hospital & facility affiliations 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1184166613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 W POLK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123723",
            "telephone_number": "312-864-6445",
            "fax_number": "312-864-9734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 W POLK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123723",
            "telephone_number": "312-864-0726",
            "fax_number": "312-864-9734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9977 Woods Dr Fl 1",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "60077",
            "country_code": "US",
            "telephone_number": "224-364-2273",
            "fax_number": "847-663-8290",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "880 W Central Rd Ste 3800",
            "address_purpose": "LOCATION",
            "city": "Arlington Hts",
            "state": "IL",
            "postal_code": "600052369",
            "country_code": "US",
            "telephone_number": "847-255-0900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHN",
        "first_name": "SMITHA",
        "credential": "APN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-15",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209015011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smitha.john@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.