Kimberly Nailah Smith, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN191043 Issued in GA

Practice address

3950 Austell Rd
Austell, GA 30106-1121

Phone

(706) 863-9595

Fax

(706) 868-8375

NPI assigned

Aug 21, 2016

Last updated

Mar 24, 2021By the provider in NPPES

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

Enrolled in GA

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 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Renewal Wound Care Georgia LLCGroup PAC ID 8022538891, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Renewal Wound Care Georgia LLC

  • Surgery Physician
  • Canton, GA
  • NPI 1558177618
  Medicare reassignment Care Compare group NPD
• Centerwell Senior Primary Care Ga PC

  dba CenterWell Senior Primary Care-Adamsville

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1043887698
  NPD
• Centerwell Senior Primary Care Ga PC

  dba CenterWell Senior Primary Care-Woodstock

  • Internal Medicine Physician
  • Woodstock, GA
  • NPI 1689491680
  NPD
• Centerwell Senior Primary Care Ga PC

  dba CenterWell Senior Primary Care-Old National

  • Internal Medicine Physician
  • South Fulton, GA
  • NPI 1801463468
  NPD

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

{
    "created_epoch": "1471737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1265987184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3726",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309143726",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 AUSTELL RD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061121",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIMBERLY",
        "middle_name": "NAILAH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-21",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN191043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael S. Slutzky, M.D
• Janay Smith
• Janis James Smith
• John Gabriel Smith, MD
• Kevin Deshaun Smith, M.D.
• Shyanne Brenda Smith, FNP
• Whitney Nicole Snow-Mielke, FNP
• Lauren S Snyder, PA-C
• Oluwatoyin Basirat Solarin, DDS
• Alaa El-Din Soltan, MD

• Nurse Practitioner in Austell, GA
• Providers in Austell, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.
• 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.