Individual provider Active NPI

Kimberly Kay Smith, RN

  • Registered Nurse
  • Scottsdale, AZ
National Provider Identifier
1083846646
Registry record updated Aug 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN127963 Issued in AZ
Practice address
9255 E Desert TRL
Scottsdale, AZ 85260-4543
Phone
(480) 661-1164
Fax
(480) 661-1164
NPI assigned
Aug 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN127963 AZ Primary

Addresses

Primary practice location

9255 E Desert TRL
Scottsdale, AZ 85260-4543

Mailing address

9255 E Desert TRL
Scottsdale, AZ 85260-4543
Phone (480) 661-1164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN127963AZMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Stellar Healthcare Services LLC Past Accepting new patients
Stellar Healthcare, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1250467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250467200000",
    "number": "1083846646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9255 E DESERT TRL",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852604543",
            "telephone_number": "480-661-1164",
            "fax_number": "480-661-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9255 E DESERT TRL",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852604543",
            "telephone_number": "480-661-1164",
            "fax_number": "480-661-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-17",
        "last_updated": "2009-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN127963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.