Marcy Smith, CNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R9390 Issued in NM

Practice address

2211 Lomas Blvd NE
2ND Floor
Albuquerque, NM 87106-2745

Phone

(505) 272-3189

Fax

(505) 272-2330

NPI assigned

Nov 7, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337126400000",
    "number": "1992786909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4504 WAYNESBORO RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871203823",
            "telephone_number": "505-897-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 LOMAS BLVD NE",
            "address_2": "2ND FLOOR",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062745",
            "telephone_number": "505-272-3189",
            "fax_number": "505-272-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARCY",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2012-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NM",
            "license": "R9390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN NUMBER",
            "identifier": "NM300999",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID NUMBER",
            "identifier": "93369",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE",
            "identifier": "R9390",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Louise Smith, PH.D.
• Linda Ann Smith, M.D.
• Lisa Mardel Smith
• Lisa Marie Smith, B.A.
• Marcus Smith
• Mark Smith, SW
• Mark Alan Smith, A.R.N.P.
• Marla J Smith, LPCC
• Mary Elizabeth Smith, DOM
• Matthew WF Smith, MBA, CCC-A

• All providers in Albuquerque, NM
• Adult Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.