Active NPI
Michelle Smith, NP
- Acute Care Nurse Practitioner
- San Tan Valley, AZ
National Provider Identifier
1376829614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- AP4238
- Practice address
- 287 E Hunt Hwy Ste 105
San Tan Valley, AZ 85143-5096 - Phone
- (480) 677-8282
- NPI assigned
- Nov 1, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Clinical Nurse Specialist | 364SC0200X | AP4238 | AZ | |
| Acute Care Nurse Practitioner | 363LA2100X | AP4238 | AZ | Primary |
Addresses
Primary practice location
287 E Hunt Hwy Ste 105
San Tan Valley, AZ 85143-5096
Mailing address
261 N Roosevelt Ave
Chandler, AZ 85226-2617
Phone (480) 677-8282
Other practice location 1
525 W Brown Rd
9th Floor
Mesa, AZ 85201-3202
Phone (480) 412-5800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 888297 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP4238 | AZ | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Leading Healthcare, LLC | Acute Care | Past | Accepting new patients |
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": "1320105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675209600000",
"number": "1376829614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "261 N ROOSEVELT AVE",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852262617",
"telephone_number": "480-677-8282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "287 E HUNT HWY STE 105",
"city": "SAN TAN VALLEY",
"state": "AZ",
"postal_code": "851435096",
"telephone_number": "480-677-8282"
}
],
"practiceLocations": [
{
"address_1": "525 W Brown Rd",
"address_2": "9th Floor",
"address_purpose": "LOCATION",
"city": "Mesa",
"state": "AZ",
"postal_code": "852013202",
"country_code": "US",
"telephone_number": "480-412-5800",
"fax_number": "480-412-5801",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "MICHELLE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-01",
"last_updated": "2023-02-01",
"certification_date": "2023-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "364SC0200X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Critical Care Medicine",
"state": "AZ",
"license": "AP4238",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "AZ",
"license": "AP4238",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "888297",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Tan Valley, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.