Individual provider Active NPI

Patricia Hicks Smith, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1467909077
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
68372 Issued in NM
Practice address
2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone
(505) 272-2111
NPI assigned
Sep 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 60776707 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 68372 NM Primary

Addresses

Primary practice location

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719

Mailing address

620 John Paul Jones Blvd.
Naval Medical Center Portsmouth
Portsmouth, VA 23708
Phone (757) 953-0651

Other identifiers 1

IdentifierTypeStateIssuer
68372OtherNMNM BON

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230607003268 TX Practitioner - Nurse Practitioner 5799111712 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68372NMMDPsychiatric/Mental Health Nurse Practitioner
60776707WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Ana Health Center CurrentSince Apr 9, 2023 Accepting new patients
Albuquerque Indian Health Center CurrentSince Apr 9, 2023 Accepting new patients

Locations

801 Vassar Dr NE
Albuquerque, NM 87106
Phone (505) 248-4000

2 Dove Rd
#C
Bernalillo, NM 87004
Phone (505) 867-2497

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Interoperability endpoints

  • Direct secure messaging: psmith336325@christushealth.direct-ci.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1467909077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES BLVD.",
            "address_2": "NAVAL MEDICAL CENTER PORTSMOUTH",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "23708",
            "telephone_number": "757-953-0651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 LOMAS BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062719",
            "telephone_number": "505-272-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PATRICIA",
        "middle_name": "HICKS",
        "name_prefix": "Dr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "60776707",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "68372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM BON",
            "identifier": "68372",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.