Tina Marrie Smith, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

219728 Issued in AZ

Practice address

200 W Hospital Dr
Whiteriver, AZ 85941

Phone

(928) 338-4911

NPI assigned

Jul 24, 2019

Sex

Female

Sole proprietor

Yes

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 TX

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

DHHS IHS Phoenix AreaGroup PAC ID 2668649567, 72 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Whiteriver PHS Indian Hospital Hospital, Whiteriver, AZ, CCN 030113
• Summit Healthcare Regional Medical Center Hospital, Show Low, AZ, CCN 030062

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• DHHS IHS Phoenix Area

  • General Acute Care Hospital
  • Whiteriver, AZ
  • NPI 1427335140

  TX

  Medicare reassignment Care Compare group NPD
• DHHS IHS Phoenix Area

  • Clinic/Center
  • Cibecue, AZ
  • NPI 1427335181
  NPD

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

• DHHS IHS Phoenix Area

  • General Acute Care Hospital
  • Whiteriver, AZ
  • NPI 1427335140
  Care Compare affiliation
• DHHS IHS Phoenix Area

  • Clinic/Center
  • Cibecue, AZ
  • NPI 1427335181

  Hospital

  Care Compare affiliation
• Summit Healthcare Association

  • Oncology Clinic/Center
  • Show Low, AZ
  • NPI 1083736128

  Hospital

  Care Compare affiliation
• Summit Healthcare Association

  • Rural Acute Care Hospital
  • Show Low, AZ
  • NPI 1144209271
  Care Compare affiliation
• Summit Healthcare Medical Associates

  • Rural Health Clinic/Center
  • Overgaard, AZ
  • NPI 1770700767

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1871147223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 N PENROD RD # 203",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859015284",
            "telephone_number": "520-780-4215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W HOSPITAL DR",
            "city": "WHITERIVER",
            "state": "AZ",
            "postal_code": "85941",
            "telephone_number": "928-338-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TINA",
        "middle_name": "MARRIE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "219728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vickie Service, PTA
• Lauren M Sheehy
• Shana Shriber, PHARMD
• Philip J Siebigteroth, PHARM.D.
• Daijonnai Maykel Smith, OTD, ATC
• Dorlette Somtia
• Kevin Bryant Spicer, M.D.
• Gerald Spinner, F.N.P.
• Anne M. Staffnik, R.D.
• Thomas Joseph Stander, O.D.

• Family Nurse Practitioner in Whiteriver, AZ
• Providers in Whiteriver, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.