Amanda Nichole Smith, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP16728 Issued in CA

Practice address

1245 Wilshire Blvd
Ste 703
Los Angeles, CA 90017-4807

Phone

(213) 977-7422

Fax

(213) 250-8945

NPI assigned

Oct 16, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1548340300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD",
            "address_2": "STE 703",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174807",
            "telephone_number": "213-977-7422",
            "fax_number": "213-250-8945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD",
            "address_2": "STE 703",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174807",
            "telephone_number": "213-977-7422",
            "fax_number": "213-250-8945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMANDA",
        "middle_name": "NICHOLE",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP16728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN603014",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aline Smith, MFT
• Alisha Smith, M.D.
• Alison Paolucci Smith
• Allison Smith
• Amanda Smith
• Amy Marie Smith, DPT
• Anais Smith
• Andrew James Smith, DPT, ATC, CSCS
• Aneesah Smith, M.D.
• Angela Smith

• Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.