Active NPI
Patricia Smith, NP
- Family Nurse Practitioner
- Salt Lake City, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 10121583-4405
- Practice address
- 409 W 400 S
Salt Lake City, UT 84101-1135 - Phone
- (802) 364-0058
- NPI assigned
- Mar 2, 2016
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 687210 | NY | |
| Family Nurse Practitioner | 363LF0000X | 9426325 | NY | |
| Family Nurse Practitioner | 363LF0000X | 10121583-4405 | UT | Primary |
Addresses
Primary practice location
409 W 400 S
Salt Lake City, UT 84101-1135
Mailing address
107 B St Apt 402
Salt Lake City, UT 84103-2449
Other practice location 1
610 Riverside Dr
apt 51
New York, NY 10031-7601
Phone (702) 523-8156
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- 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
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
7302 S Bingham Junction Blvd
Midvale, UT 84047-4804
Phone (801) 442-5502
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 687210 | NY | MD | Registered Nurse |
| 9426325 | NY | MD | Family Nurse Practitioner |
| 10121583-4405 | UT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current | Accepting new patients | |
| Wasatch Homeless Health Care, Inc. | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
7302 S Bingham Junction Blvd
Midvale, UT 84047
Phone (801) 442-3300
5373 S Green St
Ste 400
Salt Lake City, UT 84123
Phone (801) 442-2615
8955 S Harrison St
Sandy, UT 84070
Phone (801) 364-0058
409 W 400 S
Slc, UT 84101
Phone (801) 364-0058
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.
-
- Multi-Specialty Clinic/Center
- Sandy, UT
- NPI 1942325154
-
- Federally Qualified Health Center (FQHC)
- Salt Lake City, UT
- NPI 1528128899
-
- Psychiatry Physician
- Salt Lake City, UT
- NPI 1568715092
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601424000000",
"number": "1992165054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 B ST APT 402",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841032449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 W 400 S",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841011135",
"telephone_number": "802-364-0058"
}
],
"practiceLocations": [
{
"address_1": "610 Riverside Dr",
"address_2": "apt 51",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100317601",
"country_code": "US",
"telephone_number": "702-523-8156",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "PATRICIA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-02",
"last_updated": "2020-09-30",
"certification_date": "2020-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "687210",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "9426325",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "UT",
"license": "10121583-4405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.