Individual provider Active NPI

Kimberly R Smith, M.D.,

  • Internal Medicine Physician
  • New Iberia, LA
National Provider Identifier
1073500344
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
024930 Issued in LA
Practice address
520 N Lewis St
Suite 100
New Iberia, LA 70563-2094
Phone
(337) 367-8220
Fax
(337) 367-8108
NPI assigned
Oct 3, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 024930 LA Primary

Addresses

Primary practice location

520 N Lewis St
Suite 100
New Iberia, LA 70563-2094

Mailing address

520 N Lewis St
Suite 100
New Iberia, LA 70563-2094
Phone (337) 367-8220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031218000845 LA Practitioner - Internal Medicine 9830096544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

520 N Lewis St
Suite 100
New Iberia, LA 70563-2094
Phone (337) 367-8220

Hospital & facility affiliations

  • Audubon Home Health of Lafayette Home health agency, Lafayette, LA, CCN 197791
  • Iberia Medical Center Hospital, New Iberia, LA, CCN 190054
  • Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
024930LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
JKL Healthcare Services LLC Internal Medicine CurrentSince Nov 1, 2004 Accepting new patients
Hospital Service District No. 2 Past Accepting new patients
C & M Medical Services, Inc. Past Accepting new patients

Locations

520 N Lewis St
Ste 100
New Iberia, LA 70563
Phone (337) 364-5577

406 N Lewis Ave
New Iberia, LA 70563
Phone (337) 367-8220

Interoperability endpoints

  • Direct secure messaging: kimberly.smith.1@20595.direct.athenahealth.com

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1073500344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N LEWIS ST",
            "address_2": "SUITE 100",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705632094",
            "telephone_number": "337-367-8220",
            "fax_number": "337-367-8108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N LEWIS ST",
            "address_2": "SUITE 100",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705632094",
            "telephone_number": "337-367-8220",
            "fax_number": "337-367-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIMBERLY",
        "middle_name": "R",
        "credential": "M.D.,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-03",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "024930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Iberia, LA

Sources for this page

Verify at the official NPI Registry.