Active NPI
Kimberly Smith
- School Psychologist
- Ashland, KY
National Provider Identifier
1366834129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 200122906
- Practice address
- 106 Country Club Dr
Ashland, KY 41101-2136 - Phone
- (606) 371-0224
- NPI assigned
- Mar 3, 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | OH3021991 | OH | |
| School Psychologist | 103TS0200X | 200122906 | KY | Primary |
Addresses
Primary practice location
106 Country Club Dr
Ashland, KY 41101-2136
Mailing address
106 Country Club Dr
Ashland, KY 41101-2136
Phone (606) 371-0224
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20640377 | Medicaid | OH |
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 |
|---|---|---|---|
| 200122906 | KY | MD | School Psychologist |
| OH3021991 | OH | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1366834129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 COUNTRY CLUB DR",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411012136",
"telephone_number": "606-371-0224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 COUNTRY CLUB DR",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411012136",
"telephone_number": "606-371-0224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-03",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "OH",
"license": "OH3021991",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "KY",
"license": "200122906",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20640377",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ashland, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.