Phillip Wayne Smith, DNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

337695 Issued in AZ

Practice address

450 S Willard St Ste 103
Cottonwood, AZ 86326-6744

Phone

(928) 634-9573

Fax

(928) 634-0135

NPI assigned

Sep 10, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prescott Healthcare Solutions LLCGroup PAC ID 4385940295, 199 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Prescott Healthcare Solutions LLC

  dba Optima Medical

  • Family Medicine Physician
  • Prescott, AZ
  • NPI 1821454505
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1326874074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 S WILLARD ST STE 103",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863266744",
            "telephone_number": "928-634-9573",
            "fax_number": "928-634-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S WILLARD ST STE 103",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863266744",
            "telephone_number": "928-634-9573",
            "fax_number": "928-634-0135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4770 S 900 E Ste 209",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "841174616",
            "country_code": "US",
            "telephone_number": "817-480-8131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "743 Miller Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Prescott",
            "state": "AZ",
            "postal_code": "863011813",
            "country_code": "US",
            "telephone_number": "928-777-9600",
            "fax_number": "855-449-5560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PHILLIP",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-10",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "337695",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "UT",
            "license": "8991411-4405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Skipper, PTA
• Slo Austin House, LLC (Austin House Assisted Living)
• Alison Morgan Smith, PHARMD
• Larry Derrell Smith, PA-C
• Patricia Anne Smith, M.D.
• Valerie Smith, SLPA
• Smiths Food & Drug Centers Inc (Frys Food and Drug)
• Andrea Lynn Snyder, MSW, LCSW
• Corey Ellis Sonnett, PA-C
• Soundwaves,Inc

• Acute Care Nurse Practitioner in Cottonwood, AZ
• Providers in Cottonwood, AZ by specialty
• Acute Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2026; 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.