Individual provider Active NPI

Anella Susan Smith, N.P.

  • Family Nurse Practitioner
  • Aurora, CO
National Provider Identifier
1295850816
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
84136 Issued in CO
Practice address
14613 E Atlantic Dr
Aurora, CO 80014-1513
Phone
(303) 755-1566
Fax
(303) 745-3990
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 84136 CO Primary

Addresses

Primary practice location

14613 E Atlantic Dr
Aurora, CO 80014-1513

Mailing address

14613 E Atlantic Dr
Aurora, CO 80014-1513
Phone (303) 755-1566

Other identifiers 1

IdentifierTypeStateIssuer
92858236MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20050315000545 CO Practitioner - Nurse Practitioner 4385699123 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
84136COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tender Hearts Internal Medicine & Geriatric Care PC CurrentSince Apr 1, 2023 Accepting new patients
Mobile Physician Network, LLC PastSince Dec 5, 2015 Accepting new patients

Locations

7950 W Mississippi Ave
Lakewood, CO 80226
Phone (303) 422-1533

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295850816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14613 E ATLANTIC DR",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800141513",
            "telephone_number": "303-755-1566",
            "fax_number": "303-745-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14613 E ATLANTIC DR",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800141513",
            "telephone_number": "303-755-1566",
            "fax_number": "303-745-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANELLA",
        "middle_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "84136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "92858236",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.