NPIMap

Individual provider Active NPI

Tara Colleen Smith, C.N.P.

  • Family Nurse Practitioner
  • Farmington, NM
National Provider Identifier
1780136085
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP-03089 Issued in NM
Practice address
407 S Schwartz Ave Ste 201
Farmington, NM 87401-5925
Phone
(505) 609-6730
NPI assigned
Nov 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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 CNP-03089 NM Primary

Addresses

Primary practice location

407 S Schwartz Ave Ste 201
Farmington, NM 87401-5925

Mailing address

139 Scarlet Tanager Rd
Troutman, NC 28166-9508
Phone (505) 330-5355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170207000046 NM Practitioner - Nurse Practitioner 4486937034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Juan Regional Medical Center, Inc. 233 clinicians

Practice addresses (Care Compare)

120 Llano St
Aztec, NM 87410-2172
Phone (505) 334-3404

801 W Maple St
Farmington, NM 87401-5630

Hospital & facility affiliations

  • Guardian Angel Home Health, Inc Home health agency, Farmington, NM, CCN 327184
  • San Juan Regional Medical Center Inc Hospital, Farmington, NM, CCN 320005
  • Mercy Regional Medical Center Hospital, Durango, CO, CCN 060013

Merit-based Incentive Payment System (MIPS)

Final score
90.97 of 100Reported as group
Quality
79.73
Promoting interoperability
100
Improvement activities
40
Cost
78.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP-03089NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan Regional Medical Center Inc CurrentSince Dec 25, 2016 Accepting new patients
San Juan Regional Medical Center Inc Current Accepting new patients
San Juan Regional Medical Center Inc Current Accepting new patients
San Juan Regional Medical Center Inc CurrentSince Dec 25, 2016 Accepting new patients
San Juan Regional Medical Center Inc Current Accepting new patients

Locations

120 Llano St
Aztec, NM 87410
Phone (505) 334-3404

407 S Schwartz Ave
Ste 201
Farmington, NM 87401
Phone (505) 609-6300

4820 E Main St
Ste 2
Farmington, NM 87402
Phone (505) 609-6610

Organizations & group practices 8

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1780136085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 SCARLET TANAGER RD",
            "city": "TROUTMAN",
            "state": "NC",
            "postal_code": "281669508",
            "telephone_number": "505-330-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S SCHWARTZ AVE STE 201",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015925",
            "telephone_number": "505-609-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TARA",
        "middle_name": "COLLEEN",
        "name_prefix": "Mrs.",
        "credential": "C.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-03",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP-03089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.