TERRY SMITH FAMILY HEALTHCARE, PLLC
NPI 1104463330
Nurse Practitioner - Family in Flagstaff, AZ
About Terry Smith Family Healthcare, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TERRY SMITH FAMILY HEALTHCARE, PLLC (NPI 1104463330) is a healthcare organization registered as a family in Flagstaff, Arizona and active in the NPI registry since December 2019. The organization holds a CLIA Waiver certificate valid through December 8, 2027 and lists Terry Elaine Smith, Business Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Terry Smith Family Healthcare, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Terry Smith Family Healthcare, PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 03D2176101
Terry Smith Family Healthcare, PLLC · Flagstaff, AZFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Terry Smith Family Healthcare, PLLC's NPI number?
The NPI number for Terry Smith Family Healthcare, PLLC is 1104463330. It was assigned to this organization in the NPPES registry on December 6, 2019.
Where is Terry Smith Family Healthcare, PLLC located?
Terry Smith Family Healthcare, PLLC is located at 1016 W University Ave Ste 206, Flagstaff, AZ 86001. The listed phone number is (928) 606-7472.
What is Terry Smith Family Healthcare, PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Terry Smith Family Healthcare, PLLC enrolled in Medicare?
Yes. Terry Smith Family Healthcare, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Terry Smith Family Healthcare, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Terry Smith Family Healthcare, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Terry Smith Family Healthcare, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 03D2176101) is associated with this NPI, valid through December 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Terry Smith Family Healthcare, PLLC was last updated on December 6, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Terry Smith Family Healthcare, Pllc · NPI 1104463330
Family organization in Flagstaff, Arizona. Organization record, active in the CMS NPPES registry since December 6, 2019.
## Identity
- **NPI:** 1104463330 (Entity type: Organization)
- **Enumerated:** December 6, 2019
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Terry Smith, BUSINESS OWNER
## Practice location
- **Address:** 1016 W UNIVERSITY AVE STE 206, Flagstaff, AZ 86001-2996
- **Phone:** (928) 606-7472
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 6, 2019
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1104463330) · Data from the CMS NPPES public registry.