Active NPI
Kelly Whiteside Smith, CPNP
- Pediatric Nurse Practitioner
- New Orleans, LA
National Provider Identifier
1356558555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 678953
- Practice address
- 200 Henry Clay Ave
New Orleans, LA 70118-5720 - Phone
- (504) 899-9511
- NPI assigned
- May 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 678953 | TX | Primary |
Addresses
Primary practice location
200 Henry Clay Ave
New Orleans, LA 70118-5720
Mailing address
200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone (504) 899-9511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 678953 | TX | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital | Current | Accepting new patients | |
| Children'S Hospital | Current | Accepting new patients | |
| Children'S Hospital | Current | Accepting new patients |
Locations
9001 Summa Ave
Ste 342
Baton Rouge, LA 70809
Phone (225) 216-3047
200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860
Organizations & group practices 3
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422403200000",
"number": "1356558555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HENRY CLAY AVE",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701185720",
"telephone_number": "504-899-9511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HENRY CLAY AVE",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701185720",
"telephone_number": "504-899-9511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "KELLY",
"middle_name": "WHITESIDE",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-17",
"last_updated": "2015-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "TX",
"license": "678953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New Orleans, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; 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.