Individual provider Active NPI

Carron Anne Smith, NP

  • Nurse Practitioner
  • Fallbrook, CA
National Provider Identifier
1386853117
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7866 Issued in CA
Practice address
521 E Elder St
Suite 101
Fallbrook, CA 92028-3081
Phone
(760) 723-6501
Fax
(760) 723-6521
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 7866 CA Primary

Addresses

Primary practice location

521 E Elder St
Suite 101
Fallbrook, CA 92028-3081

Mailing address

27699 Jefferson Ave
Suite 300
Temecula, CA 92590-2661
Phone (951) 252-8588

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

LicenseStateTypeSpecialty
7866CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386853117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27699 JEFFERSON AVE",
            "address_2": "SUITE 300",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925902661",
            "telephone_number": "951-252-8588",
            "fax_number": "951-252-8589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E ELDER ST",
            "address_2": "SUITE 101",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283081",
            "telephone_number": "760-723-6501",
            "fax_number": "760-723-6521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CARRON",
        "middle_name": "ANNE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "7866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fallbrook, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.