Marinn Elisha Smith

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11774036-4405 Issued in UT

Practice address

701 E 700 N
Spanish Fork, UT 84660-1699

Phone

(801) 794-7947

NPI assigned

Jul 31, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Utah Valley Pediatrics L.L.C.

  • Pediatrics Physician
  • Provo, UT
  • NPI 1497812721
  NPD (past)

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1386325363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 W FOOTHILL VILLAGE BLVD",
            "city": "SANTAQUIN",
            "state": "UT",
            "postal_code": "846554635",
            "telephone_number": "385-251-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E 700 N",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601699",
            "telephone_number": "801-794-7947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARINN",
        "middle_name": "ELISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "11774036-3102",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "11774036-8900",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "11774036-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelly Smih
• Jenny Gessel Smith, CPHT
• Jeremiah Smith, CSW
• Kristie Blake Smith
• Lisa Colleen Smith, FNP-C
• Taylour C Smith, NREMT-P
• Robert Mason Snow, DPT, OCS, ATC CSCS
• Veasana Sok
• Solacium New Haven, LLC
• Solacium New Haven, LLC

• Family Nurse Practitioner in Spanish Fork, UT
• Providers in Spanish Fork, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.