Kevin E Smith, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME111943 Issued in FL

Practice address

1931 Tamiami TRL Ste 4-6
Port Charlotte, FL 33948-2181

Phone

(941) 888-0560

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevin.smith.2@7598.direct.athenahealth.com
• Direct secure messaging: kevin.smith.1@7598.direct.athenahealth.com

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.

• Florida Medical Associates LLC

  dba VIPcare

  • Primary Care Clinic/Center
  • Lady Lake, FL
  • NPI 1336153709
  Medicare reassignment NPD
• Henry County Urgent Care LLC

  • Family Medicine Physician
  • New Castle, IN
  • NPI 1811074982
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1356423420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S HARBOUR ISLAND BLVD STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025925",
            "telephone_number": "800-480-5243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 TAMIAMI TRL STE 4-6",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339482181",
            "telephone_number": "941-888-0560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13250 Hazel Dell Pkwy Ste 104",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460338527",
            "country_code": "US",
            "telephone_number": "317-415-6900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3125 S Scatterfield Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "IN",
            "postal_code": "460131804",
            "country_code": "US",
            "telephone_number": "765-298-4790",
            "fax_number": "765-298-4903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KEVIN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME111943",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01037258A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100379410",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cornelius Smith
• Dona Kristine Smith
• Joel W Smith, ATC
• Joletta A Smith
• Karen A Smith, RN
• Lindsey Smith
• Michael S Smith, PTA
• Teresa Smith
• Warren Smith, CRNA
• Donna Lynn Smolinski, D.M.D.

• Family Medicine Physician in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.