Individual provider Active NPI

Mary Helen Smith, F.N.P.

  • Community Health Registered Nurse
  • Culver City, CA
National Provider Identifier
1649373200
Registry record updated Mar 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
295050 Issued in CA
Practice address
4700 Inglewood Blvd
Suite #102
Culver City, CA 90230-5896
Phone
(310) 392-8630
Fax
(310) 664-7426
NPI assigned
Sep 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 295050 CA Primary

Addresses

Primary practice location

4700 Inglewood Blvd
Suite #102
Culver City, CA 90230-5896

Mailing address

4700 Inglewood Blvd
Suite # 102
Culver City, CA 90230-5896
Phone (310) 392-8636

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050124000754 CA Practitioner - Nurse Practitioner 1850341249 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Asian Pacific Health Care Venture, Inc. CurrentSince Aug 2, 2016 Accepting new patients
Venice Family Clinic CurrentSince Dec 1, 2004 Accepting new patients
Venice Family Clinic Current Accepting new patients
Venice Family Clinic CurrentSince Dec 1, 2004 Accepting new patients
Asian Pacific Health Care Venture, Inc. CurrentSince Aug 2, 2016 Accepting new patients
Venice Family Clinic Current Accepting new patients

Locations

9960 Baldwin Pl
El Monte, CA 91731
Phone (626) 774-2988

4216 Fountain Ave
Los Angeles, CA 90029
Phone (323) 644-3880

4700 Inglewood Blvd
Ste 102
Los Angeles, CA 90230
Phone (310) 664-7901

2509 Pico Blvd
Santa Monica, CA 90405
Phone (310) 664-7901

604 Rose Ave
Venice, CA 90291
Phone (310) 392-8630

905 Venice Blvd
Venice, CA 90291
Phone (310) 392-8630

Interoperability endpoints

  • Direct secure messaging: mary.smith.p1@direct.aphcv.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1649373200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 INGLEWOOD BLVD",
            "address_2": "SUITE # 102",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902305896",
            "telephone_number": "310-392-8636",
            "fax_number": "310-664-7426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 INGLEWOOD BLVD",
            "address_2": "SUITE #102",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902305896",
            "telephone_number": "310-392-8630",
            "fax_number": "310-664-7426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARY",
        "middle_name": "HELEN",
        "name_prefix": "Ms.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "295050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.