Active NPI
Kimberly M Smith, LICSW
- Clinical Social Worker
- Warwick, RI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW01888
- Practice address
- 215 Toll Gate Rd Ste 104
Warwick, RI 02886-4463 - Phone
- (401) 921-7290
- Fax
- (401) 921-6194
- NPI assigned
- Jul 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ISW01888 | RI | Primary |
| Clinical Social Worker | 1041C0700X | 110679 | MA |
Addresses
Primary practice location
215 Toll Gate Rd Ste 104
Warwick, RI 02886-4463
Mailing address
455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 273-0641
Other practice location 1
455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| KS78986 | Medicaid | RI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kismith@kent.cernerdirect.carene.org | Health Information Exchange (HIE) | |
| Direct Messaging Address | kismith@direct.carene.org | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110679 | MA | MD | Clinical Social Worker |
| ISW01888 | RI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affinity Physicians LLC. | Current | Accepting new patients | |
| Baxter Palliative Consulting LLC | Current | Accepting new patients | |
| Affinity Physicians LLC | Current | Accepting new patients |
Locations
55 Cherry Ln
Wakefield, RI 02879
Phone (401) 789-1367
455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000
215 Toll Gate Rd
Ste 104
Warwick, RI 02886
Phone (401) 737-9240
Interoperability endpoints
- kismith@kent.cernerdirect.carene.org
- kismith@direct.carene.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Warwick, RI
- NPI 1184944662
-
- Family Nurse Practitioner
- Wakefield, RI
- NPI 1033717228
-
- Anesthesiology Physician
- Providence, RI
- NPI 1053038471
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724976000000",
"number": "1043419617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 TOLL GATE RD",
"city": "WARWICK",
"state": "RI",
"postal_code": "028862759",
"telephone_number": "401-273-0641",
"fax_number": "401-273-2919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 TOLL GATE RD STE 104",
"city": "WARWICK",
"state": "RI",
"postal_code": "028864463",
"telephone_number": "401-921-7290",
"fax_number": "401-921-6194"
}
],
"practiceLocations": [
{
"address_1": "455 Toll Gate Rd",
"address_purpose": "LOCATION",
"city": "Warwick",
"state": "RI",
"postal_code": "028862759",
"country_code": "US",
"telephone_number": "401-737-7000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "KIMBERLY",
"middle_name": "M",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-13",
"last_updated": "2024-08-30",
"certification_date": "2024-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "ISW01888",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "110679",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "KS78986",
"state": "RI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kismith@kent.cernerdirect.carene.org",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "215 Toll Gate Rd Ste 104",
"city": "Warwick",
"state": "RI",
"country_code": "US",
"postal_code": "028864463",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kismith@direct.carene.org",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "455 Toll Gate Rd",
"city": "Warwick",
"state": "RI",
"country_code": "US",
"postal_code": "028862759",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Warwick, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.