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Nicole Renee Smith

Psychiatry & Neurology

Allopathic & Osteopathic Physicians

2150 Hillhurst Ave, Los Angeles, CA 90027-2012

PECOS Enrollment

This provider is enrolled in PECOS as NICOLE SMITH.

Based on the most recent information from CMS, provider Nicole Renee Smith is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1528453537
Provider Type
Individual
Full Name
Smith, Nicole Renee
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
4/6/2015
Last Updated
7/15/2025

Contact Information

Practice Location

2150 Hillhurst Ave, Los Angeles, CA 90027-2012

(909) 323-2461

(803) 590-6355

Mailing Location

2150 Hillhurst Ave, Los Angeles, CA 90027-2012

(909) 323-2461

(803) 590-6355

Provider Taxonomies

Code	Description	License
Code 2084P0800X Primary	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License A185171 California
Code 2084P0800X	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License MD210001441 District of Columbia
Code 2084P0800X	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License 306826 New York
Code 2084P0800X	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License D0085661 Maryland

Nicole Renee Smith

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

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License

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