Kacey Smith

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11021601 Issued in FL

Practice address

300 S Main St Unit 2
Wildwood, FL 34785-4542

Phone

(386) 299-8080

NPI assigned

Sep 19, 2022

Sex

Female

Sole proprietor

Yes

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 FL

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

Merit-based Incentive Payment System (MIPS)

Final score

94.2 of 100Reported as group

Quality

78.64

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Emergency Physicians of Central Florida LLP

  • Emergency Medicine Physician
  • Orlando, FL
  • NPI 1326033341
  Medicare reassignment NPD

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1104548981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21253 S BUCKHILL RD",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347159066",
            "telephone_number": "386-299-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S MAIN ST UNIT 2",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347854542",
            "telephone_number": "386-299-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KACEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11021601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janine Marie Shively, RN
• Shrouf Dental House
• Sinewa Dialysis LLC
• Madeline Smiddy
• Deborah Smith
• Michael William Smith, APRN, FNP-C
• Peggy Soto-Omar
• David Wayne Stephenson, MD
• Lakiesha Stokes, CNA
• Sugar-Bears Homemaker and Companion

• Nurse Practitioner in Wildwood, FL
• Providers in Wildwood, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.