NPIMap

Individual provider Active NPI

Miyoshi Smith, APRN

  • Family Nurse Practitioner
  • Sells, AZ
National Provider Identifier
1457684110
Registry record updated Oct 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP4201 Issued in AZ
Practice address
US Hwy 86 Marker 74 HC 01
San Simon Health Ctr 8178
Sells, AZ 85634-9726
Phone
(520) 362-7089
Fax
(520) 362-7080
NPI assigned
Sep 14, 2009
Last updated
Oct 24, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2011

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 AP4201 AZ Primary

Addresses

Primary practice location

US Hwy 86 Marker 74 HC 01
San Simon Health Ctr 8178
Sells, AZ 85634-9726

Mailing address

HC 1 Box 8178
Attn: San Simon Health Center US Highway 86
Sells, AZ 85634-9726
Phone (520) 362-7089

Other identifiers 1

IdentifierTypeStateIssuer
004236346MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120917000553 TX Practitioner - Nurse Practitioner 1850438250 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
004164CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS IHS Phoenix Area CurrentSince Mar 22, 2015 Accepting new patients
Ton San Xavier Health Center CurrentSince Jul 15, 2012 Accepting new patients
Ton Sells Hospital CurrentSince Jul 15, 2012 Accepting new patients
Ton San Simon Health Center CurrentSince Jul 15, 2012 Accepting new patients
Ton Santa Rosa Health Center CurrentSince Jul 15, 2012 Accepting new patients
Ton Santa Rosa Health Center Past Accepting new patients
Ton San Xavier Health Center Past Accepting new patients
Ton Sells Hospital Past Accepting new patients

Locations

7900 S J Stock Rd
Tucson, AZ 85746
Phone (520) 295-2550

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1457684110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 8178",
            "address_2": "ATTN: SAN SIMON HEALTH CENTER US HIGHWAY 86",
            "city": "SELLS",
            "state": "AZ",
            "postal_code": "856349726",
            "telephone_number": "520-362-7089",
            "fax_number": "520-362-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US HWY 86 MARKER 74 HC 01",
            "address_2": "SAN SIMON HEALTH CTR 8178",
            "city": "SELLS",
            "state": "AZ",
            "postal_code": "856349726",
            "telephone_number": "520-362-7089",
            "fax_number": "520-362-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MIYOSHI",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-14",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP4201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236346",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sells, AZ

Sources for this page

Verify at the official NPI Registry.