Individual provider Active NPI

Ciji S Smith, FNP-C

  • Family Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1609582097
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RNP290692 Issued in AZ
Practice address
2915 E Baseline Rd Ste 101
Gilbert, AZ 85234-2427
Phone
(480) 776-0626
Fax
(480) 776-0627
NPI assigned
Jan 30, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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 RNP290692 AZ Primary

Addresses

Primary practice location

2915 E Baseline Rd Ste 101
Gilbert, AZ 85234-2427

Mailing address

19125 E Mary Ann Way
Queen Creek, AZ 85142-9910
Phone (602) 513-0699

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
I20230724003149 AZ Practitioner - Nurse Practitioner 7315307261 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RNP290692AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Verve Medical Group LLC CurrentSince Jun 11, 2023 Accepting new patients
Innovative Primary Care LLC CurrentSince Nov 16, 2023 Accepting new patients
Aloha Cardiology P.C. PastSince Nov 16, 2023 Accepting new patients

Locations

2915 E Baseline Rd
Ste 101
Gilbert, AZ 85234
Phone (480) 776-0626

4824 E Baseline Rd
Ste 140
Mesa, AZ 85206
Phone (480) 969-4040

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGGEDD

Organizations & group practices 3

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": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1609582097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19125 E MARY ANN WAY",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851429910",
            "telephone_number": "602-513-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 E BASELINE RD STE 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342427",
            "telephone_number": "480-776-0626",
            "fax_number": "480-776-0627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CIJI",
        "middle_name": "S",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RNP290692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.