Individual provider Active NPI

Lisa Smalling, NP

  • Family Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1477868206
Registry record updated Aug 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19290 Issued in CA
Practice address
2653 Elm Ave Ste 100
Long Beach, CA 90806-1654
Phone
(562) 728-5027
NPI assigned
Aug 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 605253 CA
Family Nurse Practitioner 363LF0000X 19290 CA Primary

Addresses

Primary practice location

2653 Elm Ave Ste 100
Long Beach, CA 90806-1654

Mailing address

2653 Elm Ave Ste 100
Long Beach, CA 90806-1654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20201119003187 CA Practitioner - Nurse Practitioner 6002236478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Life Medical PCGroup PAC ID 5799105243, 2 clinicians

Practice addresses (Care Compare)

1777 N Bellflower Blvd
Suite 109
Long Beach, CA 90815-4019
Phone (562) 498-4455

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
605253CAMDRegistered Nurse
19290CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Zarzana Chiropractic, Inc. CurrentSince Jul 15, 2020 Accepting new patients
Great Life Medical PC CurrentSince Jul 15, 2020 Accepting new patients

Locations

1777 N Bellflower Blvd
Ste 109
Long Beach, CA 90815
Phone (562) 498-4455

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": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1477868206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2653 ELM AVE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2653 ELM AVE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061654",
            "telephone_number": "562-728-5027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLING",
        "first_name": "LISA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "605253",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "19290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.