Audrey Etta Smith

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95010044 Issued in CA

Practice address

12311 Ventura Blvd
Studio City, CA 91604-2509

Phone

(818) 762-1167

NPI assigned

Sep 18, 2018

Last updated

Sep 18, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anvar Medical GroupGroup PAC ID 4284875451, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: audrey.smith.p1@direct.thrivecmg.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Anvar Medical Group

  • Urgent Care Clinic/Center
  • Northridge, CA
  • NPI 1831539485
  Medicare reassignment Care Compare group NPD
• Ezfm Marketing Inc

  dba Professional Woundcare

  • Internal Medicine Physician
  • Lomita, CA
  • NPI 1508652066
  Medicare reassignment NPD
• FM Woundcare Inc

  • General Practice Physician
  • Lomita, CA
  • NPI 1982409579
  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Addiction Medicine (Internal Medicine) Physician
  • Tustin, CA
  • NPI 1891981502
  NPD

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1639653447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18560 VANOWEN ST UNIT 21",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913355307",
            "telephone_number": "818-632-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12311 VENTURA BLVD",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916042509",
            "telephone_number": "818-762-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AUDREY",
        "middle_name": "ETTA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95010044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Matthew Silverman, MFT
• Victoria Marie Simon, PH.D., MFT
• Sina Banankhah Dental Corporation
• Natasha Dellinger Singer, LCSW
• Marielle Skouras, MA, AMFT
• Eric Dawes Smith
• Zachary Smith, MS, CCC-SLP
• Anna Kay Smitherman, MS-CF
• Marina Snitman, PHARMD
• Amy Sobelman, LCSW

• Primary Care Nurse Practitioner in Studio City, CA
• Providers in Studio City, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.