BETTY C SMITH (NPI# 1366479172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366479172 |
| Entity Type | Individual |
| Full Name | BETTY C SMITH |
| Credential | CRNFA |
| Practice Address |
3735 N. Tabor Street Mesa AZ 85215 |
| Practice Telephone | 4806990155 |
| Practice Fax Number | 4806990155 |
| Mailing Telephone | 4806990155 |
| Mailing Fax Number | 4806990155 |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2011-12-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
RN 058867 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | HEALTNET OF AZ | 1Z5564 | 01 |
| AZ | BCBS AZ | AZ0168910 | 01 |
| AZ | 359861 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497360309 | Betty Sue Smith | Technician | 250 Heritage Ln, Glenwood, WV 25520-9752 | 2020-09-09 |
| 1790339398 | Betty Kimbler Smith | Private Vehicle | 1401 Veterans Memorial Highway, Gate City, VA 24251-2425 | 2019-07-31 |
| 1821474040 | Betty Jean Smith | Home Health Aide | 20300 Bl:oom St, Detroit, MI 48234-2408 | 2015-08-11 |
| 1508255548 | Betty Smith | Social Worker | 304 E Broadway Ave, Federal Bldg, Rm 353, Bismarck, ND 58501-4082 | 2015-01-14 |
| 1508271107 | Betty Smith | Licensed Vocational Nurse | 1101 S Main St Ste 1500b, Fort Worth, TX 76104-4802 | 2014-06-23 |
| 1922339084 | Betty Rose Smith | Counselor | 5 Codman Park, #3, Roxbury, MA 02119-1665 | 2010-01-28 |
| 1477763233 | Betty M Smith | Marriage & Family Therapist | 1954 E Bendix Dr, Tempe, AZ 85283-4237 | 2007-05-23 |
| 1740379395 | Betty L Smith | Nurse Practitioner | 6251 Phillippi Rd, Julian, NC 27283-9242 | 2006-10-12 |
| 1487192787 | Betty Ann Smith | Speech-Language Pathologist | 1920 Slabtown Rd, Lima, OH 45801-3309 | 2017-02-07 |
| 1326583360 | Betty Ann Smith | Nurse Practitioner | 201 N Bartow St, Nashville, GA 31639-1435 | 2016-12-29 |
| Street Address |
3735 N. TABOR STREET |
| City | MESA |
| State | AZ |
| Zip Code | 85215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093355356 | Kristen Eldridge | Counselor | 2929 N. Power Rd. Suite 101, Mesa, AZ 85215 | 2020-01-14 |
| 1063062149 | Makenna Francis | Nurse Practitioner | 2730 S. Val Vista Dr, 146, Mesa, AZ 85215 | 2019-09-19 |
| 1487200481 | Royalty Home Care Solutions, LLC | Assisted Living Facility | 6551 E. Menlo St, Mesa, AZ 85215 | 2019-08-15 |
| 1083170641 | Mylena Dashaun Smith | Psychologist | 2812 N. Norwalk St Bldg. 14, Ste 127 & 128, Mesa, AZ 85215 | 2019-02-19 |
| 1487134789 | Arizona Dental Professionals, P.C. | Dentist | 3218 N Recker Rd, Mesa, AZ 85215 | 2018-08-16 |
| 1619463494 | Compassion Care Home, LLC | Private Vehicle | 2863 N 64th Street, Mesa, AZ 85215 | 2018-07-05 |
| 1407293491 | Courtney D Warren | Physical Therapist | 2837 N Power Rd Ste 109, Mesa, AZ 85215 | 2013-05-30 |
| 1104182906 | Kirstin Anna Correia | Naturopath | 3405 N Higley Rd, Mesa, AZ 85215 | 2012-04-05 |
| 1154609683 | Cristy Lee Hoge | Pharmacist | 2151 N. Power Rd., Mesa, AZ 85215 | 2011-08-02 |
| 1699067546 | Fredrick G. Johnson | Registered Nurse | 4320 E Presidio St, #101, Mesa, AZ 85215 | 2011-05-11 |
| Find all providers in zip 85215 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790347292 | James M Goldhardt | Physician Assistant | 1400 S Dobson Rd Ste A200, Mesa, AZ 85202-4707 | 2019-07-03 |
| 1801305073 | Panduga Surgical Care, Pllc | Physician Assistant | 4904 S Power Rd Ste 103, Pmb 450, Mesa, AZ 85212-3610 | 2017-09-20 |
| 1114325677 | John David Shull Jr. | Physician Assistant | 1520 S Dobson Rd Ste 305, Mesa, AZ 85202 | 2014-12-16 |
| 1679826051 | Az Richardson Surgical Services, LLC | Physician Assistant | 6417 E Star Valley St, Mesa, AZ 85215-0891 | 2012-10-22 |
| 1508173014 | Karli Elizabeth Vierra | Physician Assistant | 1450 S Dobson Rd Ste 320b, Mesa, AZ 85202-4765 | 2010-09-03 |
| 1023335627 | Shawn Christopher Smith | Physician Assistant | 1432 S. Dobson Road, Suite 501, Mesa, AZ 85202 | 2010-04-23 |
| 1144460221 | April M Cadreau | Physician Assistant | 5235 E Southern Ave Ste D106-159, Mesa, AZ 85206 | 2009-03-02 |
| 1598987505 | Patricia Kim Brown | Physician Assistant | 1002 E. Sorenson St., Mesa, AZ 85203 | 2007-05-02 |
| 1275632788 | Justina D Alphin | Physician Assistant | 7525 E Broadway Rd Ste 3, Mesa, AZ 85208-1156 | 2006-09-21 |
| 1750390803 | Daniel Stephen Blake | Physician Assistant | 1839 E Enrose St, Mesa, AZ 85203-5822 | 2006-08-07 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.