Individual provider Active NPI

Terry Smith, MS,APRN, FNP-C

  • Family Nurse Practitioner
  • Flagstaff, AZ
National Provider Identifier
1477960987
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
TAP5702 Issued in AZ
Practice address
3150 N Winding Brook Rd
Flagstaff, AZ 86001-0972
Phone
(928) 556-0060
Fax
(928) 556-0015
NPI assigned
Jul 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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 TAP5702 AZ Primary

Addresses

Primary practice location

3150 N Winding Brook Rd
Flagstaff, AZ 86001-0972

Mailing address

2772 W Pico del Monte Cir
Flagstaff, AZ 86001-9197
Phone (928) 556-0060

Other practice location 1

1170 W Ardrey Cir
Flagstaff, AZ 86005-8938
Phone (928) 606-7472

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
I20140923001793 AZ Practitioner - Nurse Practitioner 3870712870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1016 W University Ave
Suite 206
Flagstaff, AZ 86001-2996
Phone (928) 266-1530

Hospital & facility affiliations

  • Flagstaff Medical Center Hospital, Flagstaff, AZ, CCN 030023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
TAP5702AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Terry Smith Family Healthcare, PLLC Family CurrentSince Dec 1, 2019 Accepting new patients

Locations

1016 W University Ave
Ste 206
Flagstaff, AZ 86001
Phone (928) 226-1530

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1477960987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2772 W PICO DEL MONTE CIR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860019197",
            "telephone_number": "928-556-0060",
            "fax_number": "928-556-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 N WINDING BROOK RD",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860010972",
            "telephone_number": "928-556-0060",
            "fax_number": "928-556-0015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1170 W Ardrey Cir",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "860058938",
            "country_code": "US",
            "telephone_number": "928-606-7472",
            "fax_number": "480-987-4417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TERRY",
        "credential": "MS,APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-16",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "TAP5702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.