Kelly Smith, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH7123 Issued in FL

Practice address

905 NE Prima Vista Blvd
Suite E
Port St Lucie, FL 34952-2359

Phone

(772) 336-8600

Fax

(772) 336-0163

NPI assigned

Sep 1, 2006

Sex

Male

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 FL

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ocean Chiropractic and Health Center IncGroup PAC ID 8527012020, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Ocean Chiropractic & Health Center, Inc.

  • Chiropractor
  • Fort Pierce, FL
  • NPI 1407929557
  Medicare reassignment Care Compare group NPD
• Itd Associates, P.a.

  • General Practice Dentistry
  • Fort Pierce, FL
  • NPI 1073832176
  NPD (past)

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1386746469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 NE PRIMA VISTA BLVD",
            "address_2": "SUITE E",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349522359",
            "telephone_number": "772-336-8600",
            "fax_number": "772-336-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 NE PRIMA VISTA BLVD",
            "address_2": "SUITE E",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349522359",
            "telephone_number": "772-336-8600",
            "fax_number": "772-336-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELLY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna D Smiley
• Mary M Smith-Collington, CNA
• Gina Alexandra Smith, MSW
• Graham Smith, HAS
• Jennifer L Smith, APRN
• Kimberly Smith
• Linda A Smith, L.C.S.W.
• Malik Smith
• Mara Smith, RD, LDN
• Martina Smith

• Chiropractor in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.