Individual provider Active NPI

Michelle Rae Smith, FNP-C

  • Family Nurse Practitioner
  • Idaho Falls, ID
National Provider Identifier
1801934831
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
61679 Issued in ID
Practice address
749 Oxford Dr
Idaho Falls, ID 83401-4203
Phone
(208) 701-2777
Fax
(208) 369-2854
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X
Family Nurse Practitioner 363LF0000X 61679 ID Primary

Addresses

Primary practice location

749 Oxford Dr
Idaho Falls, ID 83401-4203

Mailing address

749 Oxford Dr
Idaho Falls, ID 83401-4203
Phone (208) 529-2352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20231025002445 ID Practitioner - Nurse Practitioner 1254787328 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

749 Oxford Dr
Idaho Falls, ID 83401-4203
Phone (208) 701-2777

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61679IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Healthcare LLC CurrentSince Aug 22, 2023 Accepting new patients
Transformative Journey Healthcare Family CurrentSince Sep 1, 2024 Accepting new patients
Agape Birth Service and Birth Center Midwife Past Accepting new patients
Selah Midwifery Center Midwife Past Accepting new patients

Locations

749 Oxford Dr
Idaho Falls, ID 83401
Phone (208) 529-0420

530 S Holmes Ave
Idaho Falls, ID 83401
Phone (208) 529-2352

Interoperability endpoints

  • Direct secure messaging: michelle.smith@nhl-id.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1801934831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "749 OXFORD DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014203",
            "telephone_number": "208-529-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 OXFORD DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014203",
            "telephone_number": "208-701-2777",
            "fax_number": "208-369-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHELLE",
        "middle_name": "RAE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "61679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.