Individual provider Active NPI

Karl Smart

  • Psychiatric/Mental Health Nurse Practitioner
  • Athens, GA
National Provider Identifier
1124295332
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN279645 Issued in GA
Practice address
745 S Milledge Ave
Athens, GA 30605-1252
Phone
(706) 498-9560
NPI assigned
May 15, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 581186 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 17645 CA
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist 364SP0807X 2794 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN279645 GA Primary

Addresses

Primary practice location

745 S Milledge Ave
Athens, GA 30605-1252

Mailing address

411 Holman Ave
Athens, GA 30606-2666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150507002779 CA Practitioner - Nurse Practitioner 4587983861 Reassigns benefits to 1 organization
I20190111001789 GA Practitioner - Nurse Practitioner 4587983861 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Athens Hospitalist Physicians LLCGroup PAC ID 6305196411, 174 clinicians
Piedmont Athens Specialty Care LLCGroup PAC ID 8820349772, 116 clinicians

Practice addresses (Care Compare)

1199 Prince Ave
Athens, GA 30606-2797
Phone (706) 475-5076

Hospital & facility affiliations

  • Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
17645CAMDClinical Social Worker
581186CAMDPediatric Registered Nurse
RN279645GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Athens Hospitalist Physicians LLC CurrentSince Sep 1, 2023 Accepting new patients
Piedmont Athens Specialty Care LLC CurrentSince Jul 11, 2022 Accepting new patients
Personal Recovery Network LLC CurrentSince Dec 13, 2018 Accepting new patients
John Muir Physician Network CurrentSince Feb 28, 2015 Accepting new patients
Piedmont Hospitalist Physicians LLC CurrentSince Nov 30, 2023 Accepting new patients

Locations

2400 Balfour Rd
Ste 120
Brentwood, CA 94513
Phone (925) 308-8112

1450 Treat Blvd
Ste 200
Walnut Creek, CA 94597
Phone (925) 296-7340

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

35 Collier Rd NW
Ste 635
Atlanta, GA 30309
Phone (404) 367-3000

340 Exchange Blvd
Bethlehem, GA 30620
Phone (678) 963-7171

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1124295332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 HOLMAN AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 S MILLEDGE AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306051252",
            "telephone_number": "706-498-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMART",
        "first_name": "KARL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-15",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "CA",
            "license": "581186",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "17645",
            "primary": false
        },
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "CA",
            "license": "2794",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN279645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.