NPIMap

Individual provider Active NPI

Jill Elene Smothers, NP

  • Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1912104183
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
118390 Issued in CO
Practice address
2020 W Colorado Ave Ste 303
Colorado Springs, CO 80904-3882
Phone
(719) 473-2368
Fax
(719) 473-4581
NPI assigned
Jun 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704234535 MI
Nurse Practitioner 363L00000X 118390 CO Primary

Addresses

Primary practice location

2020 W Colorado Ave Ste 303
Colorado Springs, CO 80904-3882

Mailing address

2020 W Colorado Ave Ste 301
Colorado Springs, CO 80904-3882
Phone (719) 473-2368

Other identifiers 1

IdentifierTypeStateIssuer
40770044MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20080602000282 CO Practitioner - Nurse Practitioner 0446320543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2020 W Colorado Ave
Suite 303
Colorado Springs, CO 80904-3882
Phone (719) 473-2368

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704234535MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Wellness PLLC Current Accepting new patients

Locations

2020 W Colorado Ave
Ste 301
Colorado Springs, CO 80904
Phone (719) 473-2668

2020 W Colorado Ave
Ste 201
Colorado Springs, CO 80904
Phone (719) 473-3606

Organizations & group practices 2

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1912104183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 W COLORADO AVE STE 301",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809043882",
            "telephone_number": "719-473-2368",
            "fax_number": "719-473-4581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 W COLORADO AVE STE 303",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809043882",
            "telephone_number": "719-473-2368",
            "fax_number": "719-473-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOTHERS",
        "first_name": "JILL",
        "middle_name": "ELENE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704234535",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "118390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40770044",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.