Individual provider Active NPI

Patricia Smith, NP

  • Family Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1992165054
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10121583-4405 Issued in UT
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

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170814001100 UT Practitioner - Nurse Practitioner 5799056586 Reassigns benefits to 2 organizations

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
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

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

LicenseStateTypeSpecialty
687210NYMDRegistered Nurse
9426325NYMDFamily Nurse Practitioner
10121583-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Jul 7, 2020 Accepting new patients
Wasatch Homeless Health Care, Inc. CurrentSince Jun 12, 2017 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Jul 7, 2020 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.

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

Verify at the official NPI Registry.