Individual provider Active NPI

Shirley S Smith, MD

  • Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1326015827
Registry record updated Feb 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
20739 Issued in AZ
Practice address
1715 W Northern Ave Ste 108
Phoenix, AZ 85021
Phone
(602) 395-0718
Fax
(602) 277-8146
NPI assigned
Mar 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 20739 AZ Primary

Addresses

Primary practice location

1715 W Northern Ave Ste 108
Phoenix, AZ 85021

Mailing address

PO Box 35039
Phoenix, AZ 85069-5039
Phone (602) 395-0718

Other identifiers 1

IdentifierTypeStateIssuer
096265MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051129000257 AZ Practitioner - Anesthesiology 2769468461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Louisiana State University School of Medicine in Shreveport, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6350 S Maple Ave
Tempe, AZ 85283-2857
Phone (480) 345-5400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Shirley S Smith M D PLLC Anesthesiology CurrentSince Oct 3, 2002 Accepting new patients

Locations

1715 W Northern Ave
Ste 108
Phoenix, AZ 85021
Phone (602) 308-7802

3219 E Camelback Rd
Phoenix, AZ 85018
Phone (480) 561-6185

6350 S Maple Ave
Tempe, AZ 85283
Phone (480) 345-5400

Organizations & group practices 1

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": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202947200000",
    "number": "1326015827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35039",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850695039",
            "telephone_number": "602-395-0718",
            "fax_number": "602-277-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 W NORTHERN AVE STE 108",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85021",
            "telephone_number": "602-395-0718",
            "fax_number": "602-277-8146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHIRLEY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-02",
        "last_updated": "2008-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "20739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096265",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.