Individual provider Active NPI

Kayla Smith, FNP-BC

  • Family Nurse Practitioner
  • Plymouth, IN
National Provider Identifier
1487436770
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28246371A Issued in IN
Practice address
2855 Miller Dr Ste 205
Plymouth, IN 46563-8093
Phone
(260) 267-8489
Fax
(844) 909-4798
NPI assigned
Oct 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28246371A IN Primary

Addresses

Primary practice location

2855 Miller Dr Ste 205
Plymouth, IN 46563-8093

Mailing address

58071 County Road 23
Goshen, IN 46528-7722
Phone (260) 267-8489

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20240104004023 IN Practitioner - Nurse Practitioner 4688025521 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Medical PC CurrentSince Dec 3, 2023 Accepting new patients

Locations

343 S Nappanee St
Elkhart, IN 46514
Phone (574) 295-0096

250 Skillman St
Ste 204
Brooklyn, NY 11205
Phone (513) 341-7173

250 Skillman St
Ste 202
Brooklyn, NY 11205

Organizations & group practices 1

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": "1697760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1487436770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58071 COUNTY ROAD 23",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465287722",
            "telephone_number": "260-267-8489",
            "fax_number": "844-909-4798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 MILLER DR STE 205",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465638093",
            "telephone_number": "260-267-8489",
            "fax_number": "844-909-4798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KAYLA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-20",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28246371A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, IN

Sources for this page

Verify at the official NPI Registry.