Individual provider Active NPI

Chad B Nesmith

  • Professional Counselor
  • Owensboro, KY
National Provider Identifier
1083775464
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1596 Issued in AL
Practice address
3301 Wilson LN
Owensboro, KY 42303-6480
Phone
(615) 917-4972
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 283131 KY
Professional Counselor 101YP2500X 17737 CA
Professional Counselor 101YP2500X 19242 CO
Professional Counselor 101YP2500X 1596 AL Primary

Addresses

Primary practice location

3301 Wilson LN
Owensboro, KY 42303-6480

Mailing address

3750 Ralph Ave Apt 127
Owensboro, KY 42303-2204
Phone (615) 917-4972

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260123000310 CA Practitioner - Mental Health Counselor 8527545342 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

5201 Great America Pkwy
Suite 320
Santa Clara, CA 95054-1140
Phone (323) 968-6182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
19242COMDProfessional Counselor
283131KYMDProfessional Counselor
17737CAMDAcupuncturist
1596ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca CurrentSince Nov 18, 2025 Accepting new patients
Brightside Medical, P.C. Past Accepting new patients

Locations

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

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.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1083775464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 RALPH AVE APT 127",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423032204",
            "telephone_number": "615-917-4972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 WILSON LN",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423036480",
            "telephone_number": "615-917-4972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESMITH",
        "first_name": "CHAD",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "283131",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "17737",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "19242",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "1596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.