Individual provider Active NPI

Cameryn Leigh Smith, APRN

  • Family Nurse Practitioner
  • Heber City, UT
National Provider Identifier
1376185322
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10301208-4405 Issued in UT
Practice address
345 E Gateway Dr Ste 150
Heber City, UT 84032-4625
Phone
(435) 709-5201
Fax
(435) 709-5202
NPI assigned
Oct 10, 2019
Last updated
Sep 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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 10301208-4405 UT Primary

Addresses

Primary practice location

345 E Gateway Dr Ste 150
Heber City, UT 84032-4625

Mailing address

345 E Gateway Dr Ste 150
Heber City, UT 84032-4625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20211102002411 UT Practitioner - Nurse Practitioner 0749614725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wow Medical LLCGroup PAC ID 5991193526, 3 clinicians

Practice addresses (Care Compare)

150 N Main St
Suite 105
Heber City, UT 84032-1670
Phone (435) 709-5202

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10301208-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wow Medical LLC Family Medicine CurrentSince Sep 1, 2021 Accepting new patients
Heber Valley Medical LLC PastSince Sep 12, 2021 Accepting new patients
Hospice of Montana, LLC Family Medicine PastSince Jul 24, 2022 Accepting new patients
Axxis Wellness LLC PastSince Jun 12, 2022 Accepting new patients

Locations

150 N Main St
Ste 105
Heber City, UT 84032
Phone (435) 654-1377

345 E Gateway Dr
Ste 150
Heber City, UT 84032
Phone (435) 657-0101

Interoperability endpoints

  • Direct secure messaging: cameryn.smith.1@31079.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/2587/brand/1/csg/21/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1376185322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 E GATEWAY DR STE 150",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840324625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 E GATEWAY DR STE 150",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840324625",
            "telephone_number": "435-709-5201",
            "fax_number": "435-709-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CAMERYN",
        "middle_name": "LEIGH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "10301208-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Heber City, UT

Sources for this page

Verify at the official NPI Registry.