Individual provider Active NPI

Kristina Smith, APRN

  • Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1255713665
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
57292 Issued in NM
Practice address
601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619
Phone
(505) 727-8360
NPI assigned
Jun 22, 2015
Last updated
Sep 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 116684 OK
Nurse Practitioner 363L00000X 57292 NM Primary

Addresses

Primary practice location

601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619

Mailing address

500 Walter St NE Ste 308
Albuquerque, NM 87102-2562
Phone (505) 727-8360

Other practice location 1

6161 S Yale Ave
Tulsa, OK 74136-1902
Phone (918) 502-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20191101000124 NM Practitioner - Nurse Practitioner 0648583773 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57292NMMDNurse Practitioner
116684OKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Nov 4, 2019 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Nov 4, 2019 Accepting new patients
Visavis Health Care Medical Group of NM LLC CurrentSince Jun 21, 2023 Accepting new patients

Locations

103 Hospital Loop NE
Albuquerque, NM 87109
Phone (505) 348-8300

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

500 Walter St NE
Ste 308
Albuquerque, NM 87102
Phone (505) 727-8360

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

7300 State Highway 121
Ste 300374
McKinney, TX 75070

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1255713665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WALTER ST NE STE 308",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022562",
            "telephone_number": "505-727-8360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 DR MARTIN LUTHER KING JR AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023619",
            "telephone_number": "505-727-8360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6161 S Yale Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741361902",
            "country_code": "US",
            "telephone_number": "918-502-1900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRISTINA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "116684",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "57292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.