Colleen A Smith (NPI# 1104904192, PAC ID# 4789845132) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1104904192 |
| PAC ID by PECOS | 4789845132 |
| Professional Enrollment ID | I20120412000251 |
| Full Name | Colleen A Smith |
| Organization Legal Name | FAXTON - ST LUKES HEALTHCARE |
| Address |
358 Madison St Waterville NY 13480-1116 |
| Phone Number | 3158414973 |
| Gender | F |
| Graduation Year | 1997 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 2769380252 |
| Number of Group Practice Members | 150 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330044 | FAXTON-ST LUKE'S HEALTHCARE |
| 330215 | ROME MEMORIAL HOSPITAL, INC |
| 330245 | ST ELIZABETH MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 358 Madison St, Waterville, NY 13480-1116 | 3158414973 | FAXTON - ST LUKES HEALTHCARE |
| Organization Legal Name | FAXTON - ST LUKES HEALTHCARE |
| Physicians | 161 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mary-jane Elizabeth Borst | Nurse Practitioner | Faxton - St Lukes Healthcare | 3946 Oneida St, New Hartford, NY 13413-9702 |
| Alyssia M Lloyd | Nurse Practitioner | Faxton - St Lukes Healthcare | 2888 Oneida St, Sauquoit, NY 13456-3110 |
| Irena Kokot | Family Medicine | Faxton - St Lukes Healthcare | 8411 Seneca Tpke, New Hartford Medical Office, New Hartford, NY 13413-4912 |
| Jonathan D Wigderson | Orthopedic Surgery | Faxton - St Lukes Healthcare | 1903 Sunset Ave, Utica, NY 13502-5617 |
| Adam F Seigers | Family Medicine | Faxton - St Lukes Healthcare | 13460 State Route 12, Boonville, NY 13309-3531 |
| Mario Carrillo | Vascular Surgery | Faxton - St Lukes Healthcare | 1676 Sunset Ave, Utica, NY 13502-5416 |
| Nalini J Namassivaya | Pulmonary Disease | Faxton - St Lukes Healthcare | 35 Riverside Dr, Utica, NY 13502-2320 |
| John Sperling | General Surgery | Faxton - St Lukes Healthcare | 1656 Champlin Ave, New Hartford, NY 13413-1068 |
| Tatyana Misyulya | Family Medicine | Faxton - St Lukes Healthcare | 417 Trenton Ave, Utica, NY 13502-1613 |
| David P Petrie | Family Medicine | Faxton - St Lukes Healthcare | 358 Madison St, Waterville, NY 13480-1116 |
| Street Address |
358 MADISON ST |
| City | WATERVILLE |
| State | NY |
| Zip | 13480-1116 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David P Petrie | Family Medicine | Faxton - St Lukes Healthcare | 358 Madison St, Waterville, NY 13480-1116 |
| Linda A O Connor | Nurse Practitioner | Faxton - St Lukes Healthcare | 358 Madison St, Waterville, NY 13480-1116 |
| Mallory J Sullivan | Family Medicine | Faxton - St Lukes Healthcare | 358 Madison St, Waterville, NY 13480-1116 |
| Nicole R Schreck | Nurse Practitioner | Faxton - St Lukes Healthcare | 358 Madison St, Waterville, NY 13480-1116 |
| Francis Chabot | Family Medicine | Faxton - St Lukes Healthcare | 358 Madison St, Waterville, NY 13480-1116 |
| Lara B Belfiore | Nurse Practitioner | Faxton - St Lukes Healthcare | 358 Madison St, Waterville, NY 13480-1116 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Wayne R Chapman | Chiropractic | 214 E Main St, Waterville, NY 13480-1110 | |
| Shelby Sharp | Nurse Practitioner | Community Memorial Hospital | 117 W Main St, Waterville, NY 13480-1165 |
| Cheryl A Palmer | Nurse Practitioner | Community Memorial Hospital | 117 W Main St, Waterville, NY 13480-1165 |
| Michael K Walsh | Family Medicine | Community Memorial Hospital | 117 W Main St, Waterville, NY 13480-1165 |
| City | WATERVILLE |
| Zip Code | 13480 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | WATERVILLE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Colleen A Smith.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.