Individual provider Active NPI

Shelby Chantal Hope Smith, PA-C

  • Physician Assistant
  • Louisville, KY
National Provider Identifier
1407533656
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TC127 Issued in KY
Practice address
200 Abraham Flexner Way
Louisville, KY 40202-2877
Phone
(502) 587-4267
NPI assigned
Jun 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC127 KY Primary

Addresses

Primary practice location

200 Abraham Flexner Way
Louisville, KY 40202-2877

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 587-4267

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240314003861 KY Practitioner - Physician Assistant 2264878032 Reassigns benefits to 1 organization
I20260305002274 IN Practitioner - Physician Assistant 2264878032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

2125 State St
Suite 3
New Albany, IN 47150-4972
Phone (812) 542-4921

Hospital & facility affiliations

  • Baptist Health Floyd Hospital, New Albany, IN, CCN 150044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TC127KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Mar 1, 2024 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Mar 1, 2024 Accepting new patients
Baptist Health Medical Group Inc Physician Assistant CurrentSince Feb 1, 2026 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Feb 1, 2026 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

2125 State St
Ste 3
New Albany, IN 47150
Phone (812) 949-5575

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

200 Abraham Flexner Way
Louisville, KY 40202
Phone (502) 569-7983

Organizations & group practices 6

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": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1407533656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-587-4267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ABRAHAM FLEXNER WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022877",
            "telephone_number": "502-587-4267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHELBY",
        "middle_name": "CHANTAL HOPE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-29",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.