Individual provider Active NPI

Millissa K Smith, FNP-C

  • Family Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1396384715
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
235926 Issued in AZ
Practice address
5555 W Thunderbird Rd
Glendale, AZ 85306-4622
Phone
(602) 865-5445
NPI assigned
Jan 2, 2020
Last updated
Sep 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 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 235926 AZ Primary

Addresses

Primary practice location

5555 W Thunderbird Rd
Glendale, AZ 85306-4622

Mailing address

5555 W Thunderbird Rd
Glendale, AZ 85306-4622
Phone (602) 865-5445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20201015000745 AZ Practitioner - Nurse Practitioner 2163842097 Reassigns benefits to 2 organizations

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

Practice addresses (Care Compare)

5757 W Thunderbird Rd
Suite E250
Glendale, AZ 85306-4641
Phone (602) 865-4470

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.42 of 100Reported as group
Quality
62.19
Promoting interoperability
99
Improvement activities
40
Cost
61.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
235926AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Cancer Center Specialists LLC CurrentSince Oct 12, 2020 Accepting new patients
Banner Cancer Center Specialists LLC CurrentSince Oct 12, 2020 Accepting new patients
Signify Health, LLC Nurse Practitioner CurrentSince Jul 18, 2023 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Oct 1, 2020 Accepting new patients

Locations

2705 S Alma School Rd
Chandler, AZ 85286
Phone (480) 820-7246

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-5450

2946 E Banner Gateway Dr
Rm 2008
Gilbert, AZ 85234
Phone (480) 256-4523

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

5757 W Thunderbird Rd
Ste E250
Glendale, AZ 85306
Phone (602) 865-4470

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

3800 N Central Ave
Ste 460
Phoenix, AZ 85012
Phone (469) 466-7006

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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 3

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": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1396384715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064622",
            "telephone_number": "602-865-5445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064622",
            "telephone_number": "602-865-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MILLISSA",
        "middle_name": "K",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-02",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "235926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.