Kaysie Nichole Smith

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C014755 Issued in NC

Practice address

3314 16TH Ave SE Ste 205
Conover, NC 28613-9694

Phone

(866) 700-1606

Fax

(866) 338-5921

NPI assigned

May 20, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1093372674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "486 SPAULDING RD",
            "city": "MARION",
            "state": "NC",
            "postal_code": "287525212",
            "telephone_number": "828-652-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3314 16TH AVE SE STE 205",
            "city": "CONOVER",
            "state": "NC",
            "postal_code": "286139694",
            "telephone_number": "866-700-1606",
            "fax_number": "866-338-5921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "486 Spaulding Rd",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "NC",
            "postal_code": "287525212",
            "country_code": "US",
            "telephone_number": "828-652-2919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KAYSIE",
        "middle_name": "NICHOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-20",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P013359",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C014755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole W Sherrill, MSW, LCSWA
• William Walter Sherrod, DDS
• Ronald James Shokes, R.PH.
• Alicia B Sigmon, P.A.-C
• Sipes Orchard Home
• Susan Tinkelenberg Snyder, PT
• Irene Spallino, CCC-SLP
• Lynn B. Spees, M. D.
• Spring Road Rest Home
• Brian David Steg, M.D.

• Clinical Social Worker in Conover, NC
• Providers in Conover, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; 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.