Kimberly Denise Smith, CPC

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

60756167 Issued in WA

Practice address

720 14TH Ave FL 2
Longview, WA 98632-2315

Phone

(360) 423-0203

Fax

(360) 423-7086

NPI assigned

Aug 15, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1184140881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 14TH AVE FL 2",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322315",
            "telephone_number": "360-423-0203",
            "fax_number": "360-423-7086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 14TH AVE FL 2",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322315",
            "telephone_number": "360-423-0203",
            "fax_number": "360-423-7086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIMBERLY",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "CPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": "60756167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolina Kato Smith, MD
• Emily A Smith, BS, R-AAC
• Fran J Smith, MSW
• Ian Michael Smith, CPO
• Jessica K Smith
• Kylah Archelle Smith
• Lyndsey Smith, DENTAL HYGIENIST
• Raquel Smith, BS, AAC
• Ryan Smith
• Whitney Marie Smith, LPN

• Peer Specialist in Longview, WA
• Providers in Longview, WA by specialty
• Peer Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.