Individual provider Active NPI

Alexandra Smith, FNP

  • Family Nurse Practitioner
  • Liberty, MO
National Provider Identifier
1548736655
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2018035122 Issued in MO
Practice address
109 N Blue Jay Dr
Liberty, MO 64068-1906
Phone
(816) 691-1424
Fax
(816) 480-4511
NPI assigned
Oct 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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 2018035122 MO Primary

Addresses

Primary practice location

109 N Blue Jay Dr
Liberty, MO 64068-1906

Mailing address

901 E 104TH St
Kansas City, MO 64131-4517
Phone (816) 436-7072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200408001896 KS Practitioner - Nurse Practitioner 7416200860 Reassigns benefits to 1 organization
I20230616000037 CO Practitioner - Nurse Practitioner 7416200860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Urgent Care ColoradoGroup PAC ID 7214295989, 23 clinicians

Practice addresses (Care Compare)

110 E Boardwalk
Fort Collins, CO 80525-3047
Phone (970) 821-1500

2555 E 13TH St
Suite 110
Loveland, CO 80537-5134
Phone (970) 820-4264

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Urgent Care Colorado CurrentSince Aug 1, 2023 Accepting new patients
Banner Urgent Care Colorado Current Accepting new patients
Meritas Health Corporation Past Accepting new patients
Carespot Professional Services LLC PastSince Aug 4, 2015 Accepting new patients
Meritas Health Corporation Past Accepting new patients

Locations

2001 70th Ave
Ste 110
Greeley, CO 80634
Phone (970) 378-4155

2555 E 13th St
Ste 110
Loveland, CO 80537
Phone (970) 461-6140

Organizations & group practices 6

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": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1548736655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 104TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641314517",
            "telephone_number": "816-436-7072",
            "fax_number": "816-436-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N BLUE JAY DR",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681906",
            "telephone_number": "816-691-1424",
            "fax_number": "816-480-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ALEXANDRA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-16",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018035122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

Verify at the official NPI Registry.