Shane Ray Smith, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

300208 Issued in AZ

Practice address

10230 W Happy Valley Pkwy
Peoria, AZ 85383-4691

Phone

(623) 561-3030

NPI assigned

Aug 10, 2023

Last updated

Nov 15, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

HonorhealthGroup PAC ID 1456258607, 66 clinicians

Honorhealth Urgent Care LLCGroup PAC ID 0345130266, 103 clinicians

Emcare - PNX Emergency Physicians LLCGroup PAC ID 3779574165, 66 clinicians

303 Emergency Physicians PLLCGroup PAC ID 2567692528, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Honor Health John C. Lincoln Medical Center Hospital, Phoenix, AZ, CCN 030014
• Honorhealth Sonoran Crossing Medical Center Hospital, Phoenix, AZ, CCN 030146

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssmith13090@direct.honorhealth.com

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.

• 303 Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Yuma, AZ
  • NPI 1518398585

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Emcare - PNX Emergency Physicians LLC

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1902855992

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Honorhealth

  dba HonorHealth Contract Providers

  • Surgery Physician
  • Scottsdale, AZ
  • NPI 1801092564
  Medicare reassignment Care Compare group NPD
• Honorhealth Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1740273614
  Medicare reassignment Care Compare group NPD
• Loop 101 Emergency Physicians LLC

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1376573378

  Nurse Practitioner

  Medicare reassignment NPD
• Honorhealth

  dba HonorHealth Tina's Treasures

  • Prosthetic/Orthotic Supplier
  • Peoria, AZ
  • NPI 1386456762
  NPD
• Honorhealth

  dba HonorHealth Scottsdale Osborn Medical Center

  • General Acute Care Hospital
  • Scottsdale, AZ
  • NPI 1811951429
  NPD
• Honorhealth Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Scottsdale, AZ
  • NPI 1700423415
  NPD

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

• Honorhealth

  dba HonorHealth Sonoran Crossing Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1265063010
  Care Compare affiliation
• Honorhealth

  dba HonorHealth John C. Lincoln Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1770690695
  Care Compare affiliation

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1326721796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21735 N 119TH DR",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853735650",
            "telephone_number": "623-628-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10230 W HAPPY VALLEY PKWY",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853834691",
            "telephone_number": "623-561-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHANE",
        "middle_name": "RAY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "300208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Carmen Smith, BSN, RN
• Johnny Lee Smith, D.M.D.
• Kerry Smith
• Lori Smith, LPC
• Madison Rose Smith, PT, DPT
• Shiona Marie Smith, PA-C
• Stefani Dionne Smith
• Tawnee Rae Smith
• Todd R. Smith, O.D.
• Zachary Smith

• Nurse Practitioner in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.