Individual provider Active NPI

Kimberly C Smith, M.D.

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1104854330
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
H2023 Issued in TX
Practice address
6410 Fannin St
500
Houston, TX 77030-3000
Phone
(832) 325-7111
Fax
(713) 500-5711
NPI assigned
Jun 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X H2023 TX Primary

Addresses

Primary practice location

6410 Fannin St
500
Houston, TX 77030-3000

Mailing address

PO Box 201088
Houston, TX 77216-1088
Phone (713) 500-3500

Other identifiers 1

IdentifierTypeStateIssuer
89Y070OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050726000402 TX Practitioner - Pediatric Medicine 4880621481 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Aug 4, 2010 Accepting new patients
Ut Physicians Pediatrics CurrentSince Aug 4, 2010 Accepting new patients
Pasadena Health Center, Inc Past Accepting new patients
Harris County Hospital District Past Accepting new patients
Ut Physicians Pediatrics Past Accepting new patients

Locations

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

524 Pasadena Blvd
Ste 1001
Pasadena, TX 77506
Phone (713) 554-1091

Interoperability endpoints

  • Direct secure messaging: kimberlyc.smith@direct.memorialhermann.org
  • Direct secure messaging: ksmith12951@direct.uth.org

Organizations & group practices 5

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1104854330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 201088",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772161088",
            "telephone_number": "713-500-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST",
            "address_2": "500",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303000",
            "telephone_number": "832-325-7111",
            "fax_number": "713-500-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIMBERLY",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "H2023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "89Y070",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.