NPIMap

Organization Active NPI

Keyoka S Smith DPM LLC

  • Podiatric Clinic/Center
  • Columbia, SC
National Provider Identifier
1164816211
Registry record updated Aug 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
License
622 Issued in SC
Legal business name
KEYOKA S SMITH DPM LLC
Practice address
4100 N Main St Ste 202
Columbia, SC 29203-5800
Phone
(803) 570-2209
NPI assigned
Mar 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2020

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

Authorized official

Name
Keyoka Sheree Smith, DPMNPI 1952612871
Title
Podiatrist/Owner
Phone
(803) 570-2209

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X 622 SC Primary

Addresses

Primary practice location

4100 N Main St Ste 202
Columbia, SC 29203-5800

Mailing address

PO Box 705
Columbia, SC 29202-0705
Phone (803) 570-2209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150326000389 SC Part B Supplier - Clinic/Group Practice 0244557569 Receives reassigned benefits from 1 practitioner
Practice locations: Columbia, SC

National Provider Directory

National Provider Directory

Locations

4100 N Main St
Ste 200
Columbia, SC 29203
Phone (803) 570-2209

4100 N Main St
Ste 202
Columbia, SC 29203
Phone (803) 530-0354

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598745600000",
    "number": "1164816211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 705",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292020705",
            "telephone_number": "803-570-2209",
            "fax_number": "888-866-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 N MAIN ST STE 202",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292035800",
            "telephone_number": "803-570-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYOKA S SMITH DPM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-26",
        "last_updated": "2020-08-30",
        "certification_date": "2020-08-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KEYOKA",
        "authorized_official_middle_name": "SHEREE",
        "authorized_official_title_or_position": "PODIATRIST/OWNER",
        "authorized_official_telephone_number": "803-570-2209",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "SC",
            "license": "622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.