Peggy Ann Smith, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP30006974 Issued in WA

Practice address

4114 Bridgeport Way W
University Place, WA 98466-4315

Phone

(253) 564-4157

Fax

(253) 220-2491

NPI assigned

Jan 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians

Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
• Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• CS Pacs 3 Northwest, LLC

  • Hospitalist Physician
  • Puyallup, WA
  • NPI 1811752066
  Medicare reassignment NPD
• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• Wa Pacs 2 PC

  • Hospitalist Physician
  • Tacoma, WA
  • NPI 1144706532
  Medicare reassignment NPD
• Washington Pac Services PC

  • Hospitalist Physician
  • Spokane, WA
  • NPI 1336678168
  Medicare reassignment NPD
• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248
  Care Compare group
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  • Community/Behavioral Health Agency
  • Auburn, WA
  • NPI 1861872178
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Franciscan Health System

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1124291117
  Care Compare affiliation
• Franciscan Health System

  • Clinical Medical Laboratory
  • Tacoma, WA
  • NPI 1659585370

  Hospital

  Care Compare affiliation
• Franciscan Health System

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1952309098
  Care Compare affiliation
• Multicare Health System

  • General Acute Care Hospital
  • Puyallup, WA
  • NPI 1841231461
  Care Compare affiliation

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1467504084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 BRIDGEPORT WAY W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664315",
            "telephone_number": "253-564-4157",
            "fax_number": "253-220-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4114 BRIDGEPORT WAY W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664315",
            "telephone_number": "253-564-4157",
            "fax_number": "253-220-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PEGGY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30006974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTARED NURSE LICENSE",
            "identifier": "RN00138953",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY NURSE PRACTITIONER",
            "identifier": "20040025-22",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LICENSE NUMBER",
            "identifier": "AP30006974",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fransje Jereontje Slothouber Giles, DNP, NP-C
• Kimberly Dawn Smeall, BA
• Gretchen Smith, MSW
• Kelli Smith
• Kenneth Ray Smith Jr.
• Rashanna Smith, LMP
• Carmilla Solomon, EDD LMHC
• James Neak Son, DDS
• Grace Song, DDS
• Trinity Songha, LMFTA

• Family Nurse Practitioner in University Place, WA
• Providers in University Place, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.