Active NPI
Mekenzie Nelson
- Student in an Organized Health Care Education/Training Program
- Loma Linda, CA
National Provider Identifier
1740145929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 24785 Stewart St
Loma Linda, CA 92350-1721 - Phone
- (909) 558-7295
- NPI assigned
- Dec 18, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
24785 Stewart St
Loma Linda, CA 92350-1721
Mailing address
24785 Stewart St
Loma Linda, CA 92350-1721
Phone (909) 558-7295
Other names 1
- Mekenzie Smotherman
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Loma Linda University School of Medicine, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
13555 Bowman Rd
Suite 100
Auburn, CA 95603-3156
Hospital & facility affiliations
- Sutter Auburn Faith Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Auburn, CA
- NPI 1851603278
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Auburn, CA
- NPI 1194774299
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1766016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766016000000",
"number": "1740145929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24785 STEWART ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923501721",
"telephone_number": "909-558-7295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24785 STEWART ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923501721",
"telephone_number": "909-558-7295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "MEKENZIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-12-18",
"last_updated": "2025-12-18",
"certification_date": "2025-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MEKENZIE",
"last_name": "SMOTHERMAN",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; 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.