Clarisa I. Smith, MD PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35537 Issued in AZ

Legal business name

CLARISA I. SMITH, MD PLLC

Doing business as

Yavapai Pediatrics

Practice address

3001 N Main St
Suite 1C
Prescott Valley, AZ 86314-1216

Phone

(928) 458-5470

Fax

(928) 458-5979

NPI assigned

May 8, 2013

Organization subpart

No

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

Authorized official

Name

Kirsten A Sorensen

Title

Administrator

Phone

(602) 431-1152

Specialties & licenses 1

Addresses

Other names 1

• Yavapai Pediatrics Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christen Glennan, RN, MS, CPNP

  • Pediatric Nurse Practitioner
  • Prescott Valley, AZ
  • NPI 1417106824
  NPD (past)
• Hayley Lynn Fernandez de Cordova, PA-C

  • Physician Assistant
  • Chicago, IL
  • NPI 1295163152
  NPD (past)

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

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378771200000",
    "number": "1609211291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CHESTER AVE",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214033311",
            "telephone_number": "602-431-1152",
            "fax_number": "602-431-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 N MAIN ST",
            "address_2": "SUITE 1C",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141216",
            "telephone_number": "928-458-5470",
            "fax_number": "928-458-5979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARISA I. SMITH, MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-08",
        "last_updated": "2013-09-10",
        "status": "A",
        "authorized_official_last_name": "SORENSEN",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-431-1152"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "35537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yavapai Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sheryl D Chrisman, LMT
• Emilie Ann Christman, LMSW
• Kyle Frederick Chun, M.D.
• CK Health LLC
• Louise Clara, NP-C
• Derek Clark, PHARMD
• Joey Allen Clayton, PA-C
• Stephanie Lynne Clinton, LPN
• Patricia Jane Coates, APRN
• Judy Kaye Cobos, NP

• Pediatrics Physician in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.