Kimberly Marie Smith, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN135643 Issued in GA

Practice address

1000 Medical Center Blvd
Lawrenceville, GA 30045-7694

Phone

(678) 442-4350

NPI assigned

Jun 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Gwinnett Emergency Specialists Observation Services, LLC

  • Emergency Medicine Physician
  • Lawrenceville, GA
  • NPI 1720373129
  Medicare reassignment NPD
• Gwinnett Emergency Specialists, LLC

  • Emergency Medicine Physician
  • Lawrenceville, GA
  • NPI 1437346467
  Medicare reassignment NPD

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083818397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 TIMBERWOLF CT",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305194368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300457694",
            "telephone_number": "678-442-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN135643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joycelyn S Smith, MS, LPC
• Julie Anne Smith, APRN, PMHNP-BC
• Kathleen Marie Smith, RN
• Keena Michelle Smith, MA, CCC-SLP
• Kenyona L Smith
• Laquetta Smith
• Latoya Smith, PHD
• Latoya Lenae Smith, LCSW
• Marjorie Smith, CFNP
• Mehala A Smith, M.S.W.

• Family Nurse Practitioner in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.