Individual provider Active NPI

Lauren Victoria Russell-Smith, FNP

  • Nurse Practitioner
  • Davis, CA
National Provider Identifier
1386225514
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
28562 Issued in TN
Practice address
33100 County Road 31
Davis, CA 95616-9523
Phone
(530) 702-6000
NPI assigned
Apr 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 28562 TN Primary

Addresses

Primary practice location

33100 County Road 31
Davis, CA 95616-9523

Mailing address

8123 Helmsdale Dr
Sacramento, CA 95828-5599
Phone (601) 850-6617

Other practice location 1

39990 Faure Rd
Hemet, CA 92544-9408
Phone (951) 708-4020

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

State licenses

LicenseStateTypeSpecialty
28562TNMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1386225514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8123 HELMSDALE DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958285599",
            "telephone_number": "601-850-6617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33100 COUNTY ROAD 31",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956169523",
            "telephone_number": "530-702-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39990 Faure Rd",
            "address_purpose": "LOCATION",
            "city": "Hemet",
            "state": "CA",
            "postal_code": "925449408",
            "country_code": "US",
            "telephone_number": "951-708-4020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL-SMITH",
        "first_name": "LAUREN",
        "middle_name": "VICTORIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-19",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "28562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.

Verify at the official NPI Registry.