Individual provider Active NPI

Kathryn L. Smith, PA-C

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1477874642
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1897 Issued in OK
Practice address
2140 S Yale Ave
Tulsa, OK 74114-2122
Phone
(918) 712-9342
NPI assigned
Jun 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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 1897 OK Primary

Addresses

Primary practice location

2140 S Yale Ave
Tulsa, OK 74114-2122

Mailing address

2140 S Yale Ave
Tulsa, OK 74114-2122
Phone (918) 712-9342

Other identifiers 1

IdentifierTypeStateIssuer
1477874642MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20170106000320 OK Practitioner - Physician Assistant 3577743244 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hillcrest Urgent Care, LLCGroup PAC ID 6608393715, 41 clinicians

Practice addresses (Care Compare)

10221 E 81St St
Tulsa, OK 74133-4559
Phone (918) 252-9300

1217 E 48TH St
Suite 100
Tulsa, OK 74105-4701
Phone (918) 528-4897

1623 S Utica Ave
Tulsa, OK 74104-4909
Phone (918) 392-5100

2140 S Yale Ave
Tulsa, OK 74114-2122
Phone (918) 712-9342

9716 Riverside Pkwy
Suite 100
Tulsa, OK 74137-7450
Phone (918) 528-4897

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1897OKMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: kathryn.smithpac.p8@direct.nextcare.nextgenshare.com
  • Direct secure messaging: kathryn.smithpac.p10@direct.nextcare.nextgenshare.com
  • Direct secure messaging: ksmith1339374@ahs.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1477874642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741142122",
            "telephone_number": "918-712-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741142122",
            "telephone_number": "918-712-9342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATHRYN",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-22",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477874642",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.