Individual provider Active NPI

Kylie Smith

  • Occupational Therapist
  • Oak Harbor, WA
National Provider Identifier
1174190144
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
785 SE Bayshore Dr Ste 102
Oak Harbor, WA 98277-3275
Phone
(360) 279-8323
Fax
(360) 279-8772
NPI assigned
Jun 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

785 SE Bayshore Dr Ste 102
Oak Harbor, WA 98277-3275

Mailing address

785 SE Bayshore Dr Ste 102
Oak Harbor, WA 98277-3275
Phone (360) 279-8323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210908002016 WA Practitioner - Occupational Therapist in Private Practice 9537565080
I20220803002293 NC Practitioner - Occupational Therapist in Private Practice 9537565080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Specialists of North Carolina, P.a.Group PAC ID 7810974375, 49 clinicians

Practice addresses (Care Compare)

11081 Forest Pines Dr
Suite 112
Raleigh, NC 27614-7656
Phone (919) 562-9410

Merit-based Incentive Payment System (MIPS)

Final score
83.06 of 100Reported as group
Quality
61.01
Promoting interoperability
100
Improvement activities
40
Cost
82.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Specialists of North Carolina, P.a. CurrentSince Jul 26, 2022 Accepting new patients
Orthopaedic Specialists of North Carolina, P.a. Occupational Therapist CurrentSince Jul 26, 2022 Accepting new patients

Locations

11211 Galleria Ave
Ste 106
Raleigh, NC 27614

11221 Galleria Ave
#101
Raleigh, NC 27614
Phone 9195629410213

11200 Governor Manly Way
Ste 309
Raleigh, NC 27614
Phone 9195629410247

11081 Forest Pines Dr
Ste 112
Raleigh, NC 27614
Phone (252) 478-3736

5838 Six Forks Rd
Ste 300
Raleigh, NC 27609
Phone (919) 782-5954

Organizations & group practices 2

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": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1174190144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 SE BAYSHORE DR STE 102",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982773275",
            "telephone_number": "360-279-8323",
            "fax_number": "360-279-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 SE BAYSHORE DR STE 102",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982773275",
            "telephone_number": "360-279-8323",
            "fax_number": "360-279-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KYLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.