Individual provider Active NPI

Kathleen Smith, NP

  • Nurse Practitioner
  • Providence, RI
National Provider Identifier
1407193535
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP37733 Issued in RI
Practice address
593 Eddy St
Claverick 2
Providence, RI 02903-4923
Phone
(401) 854-2504
Fax
(401) 854-2519
NPI assigned
Jan 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP37733 RI Primary

Addresses

Primary practice location

593 Eddy St
Claverick 2
Providence, RI 02903-4923

Mailing address

PO Box 9484
Providence, RI 02940-9484
Phone (401) 854-2504

Other names 1

  • Kathleen Williamson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ksmith13086@direct.lifespan.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130423000204 RI Practitioner - Nurse Practitioner 9436395274 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Medical Physicians IncGroup PAC ID 0345658316, 222 clinicians

Practice addresses (Care Compare)

900 Warren Ave
Suite 401
East Providence, RI 02914-1430
Phone (401) 330-2480

Hospital & facility affiliations

  • The Miriam Hospital Hospital, Providence, RI, CCN 410012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP37733RIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Physicians, Inc. Nurse Practitioner CurrentSince Apr 25, 2021 Accepting new patients
Coastal Medical Physicians, Inc. CurrentSince Apr 25, 2021 Accepting new patients
Emergency Physician Associates of New England PC Nurse Practitioner CurrentSince May 1, 2014 Accepting new patients
Lifespan Corporation Current Accepting new patients
Brown Emergency Medicine Nurse Practitioner CurrentSince Apr 1, 2013 Accepting new patients
Lifespan Physician Group Inc CurrentSince Feb 1, 2026 Accepting new patients
Lifespan Physician Group, Inc. Nurse Practitioner CurrentSince Feb 1, 2026 Accepting new patients
Coastal Medical, Inc. Past Accepting new patients

Locations

1598 S County Trl
Ste 201
East Greenwich, RI 02818
Phone (401) 884-0333

900 Warren Ave
Ste 400
East Providence, RI 02914
Phone (401) 331-1221

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

593 Eddy St
#2
Providence, RI 02903
Phone (401) 519-1604

593 Eddy St
Providence, RI 02903

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

41 Sanderson Rd
Ste 201
Smithfield, RI 02917
Phone (401) 253-3710

59 South County Commons Way
Fl 2
South Kingstown, RI 02879
Phone (401) 738-4323

100 Kenyon Ave
Wakefield, RI 02879
Phone (401) 782-8000

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

  • Direct secure messaging: ksmith13086@brownhealth.medalliesdirect.net

Organizations & group practices 9

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1407193535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9484",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029409484",
            "telephone_number": "401-854-2504",
            "fax_number": "401-854-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "CLAVERICK 2",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-854-2504",
            "fax_number": "401-854-2519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATHLEEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-09",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "NP37733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksmith13086@direct.lifespan.org",
            "affiliation": "N",
            "address_1": "900 Warren Ave Ste 401",
            "city": "East Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029141430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "WILLIAMSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.