Active NPI
Kallie Smith, ATC, LAT
- Athletic Trainer
- Little Rock, AR
National Provider Identifier
1356728273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT679
- Practice address
- 800 Fair Park Blvd
Little Rock, AR 72204-1720 - Phone
- (501) 500-3500
- NPI assigned
- Apr 29, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT679 | AR | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
800 Fair Park Blvd
Little Rock, AR 72204-1720
Mailing address
505 E Horizon Rd
Ward, AR 72176-8608
Phone (870) 613-0870
Other practice location 1
63 Barrenfork Road
MT Pleasant, AR 72561
Phone (870) 613-0870
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kallie.johnson@orthoarkansas.com | Direct | OrthoArkansas, PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT679 | AR | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622073600000",
"number": "1356728273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 E HORIZON RD",
"city": "WARD",
"state": "AR",
"postal_code": "721768608",
"telephone_number": "870-613-0870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 FAIR PARK BLVD",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722041720",
"telephone_number": "501-500-3500"
}
],
"practiceLocations": [
{
"address_1": "63 Barrenfork Road",
"address_purpose": "LOCATION",
"city": "MT Pleasant",
"state": "AR",
"postal_code": "72561",
"country_code": "US",
"telephone_number": "870-613-0870",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "KALLIE",
"credential": "ATC, LAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-29",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AR",
"license": "AT679",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kallie.johnson@orthoarkansas.com",
"affiliation": "Y",
"endpointDescription": "work email",
"affiliationName": "OrthoArkansas, PA",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "800 Fair Park Blvd",
"city": "Little Rock",
"state": "AR",
"country_code": "US",
"postal_code": "722041720",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.