Katie M Smith, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

01712 Issued in WV

Practice address

30 Medical Park
Suite 211
Wheeling, WV 26003-6391

Phone

(304) 233-6301

Fax

(304) 233-8803

NPI assigned

Oct 25, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WV, OH2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Wheeling Hospital Inc

  • Family Medicine Physician
  • Wheeling, WV
  • NPI 1548923923

  OH

  Medicare reassignment NPD
• Wheeling Hospital Inc

  • General Acute Care Hospital
  • Wheeling, WV
  • NPI 1104821305
  NPD (past)
• Wheeling Hospital Inc

  • Clinic/Center
  • Wheeling, WV
  • NPI 1558664037
  NPD (past)

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1174876387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MEDICAL PARK",
            "address_2": "SUITE 211",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036391",
            "telephone_number": "304-233-6301",
            "fax_number": "304-233-8803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MEDICAL PARK",
            "address_2": "SUITE 211",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036391",
            "telephone_number": "304-233-6301",
            "fax_number": "304-233-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATIE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-25",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "124",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "01712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Maria Smith, PA-C
• Angela Raye Smith, CRNA
• Antonio Lee Smith
• Jeremy Smith
• Kaitlyn Ann Smith
• Kelsey Jo Smith
• Lori Smith
• Lori Smith, PT
• Markeisha Smith
• Melissa Smith

• Medical Physician Assistant in Wheeling, WV
• Providers in Wheeling, WV by specialty
• Medical Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.