Individual provider Active NPI

Charmaine Poling Smith, ARNP

  • Family Nurse Practitioner
  • Peyton, CO
National Provider Identifier
1487627295
Registry record updated Aug 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
107505 Issued in CO
Practice address
9381 Morfontaine Rd
Peyton, CO 80831-4024
Phone
(719) 494-8483
NPI assigned
Feb 10, 2006
Last updated
Aug 7, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2007

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 107505 CO Primary

Addresses

Primary practice location

9381 Morfontaine Rd
Peyton, CO 80831-4024

Mailing address

9381 Morfontaine Rd
Peyton, CO 80831-4024
Phone (719) 494-8483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20170508000862 CO Order and Referring Only - Nurse Practitioner 3971880600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107505COMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186444800000",
    "number": "1487627295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9381 MORFONTAINE RD",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808314024",
            "telephone_number": "719-494-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9381 MORFONTAINE RD",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808314024",
            "telephone_number": "719-494-8483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARMAINE",
        "middle_name": "POLING",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2007-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "107505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peyton, CO

Sources for this page

Verify at the official NPI Registry.