Kelly J Smith, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704152480 Issued in MI

Practice address

200 N Park St
West Michigan Cancer Center
Kalamazoo, MI 49007-3731

Phone

(269) 382-2500

Fax

(269) 373-7478

NPI assigned

Mar 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Merit-based Incentive Payment System (MIPS)

Final score

86.43 of 100Reported as group

Quality

75.38

Promoting interoperability

100

Improvement activities

40

Cost

79.38

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: direct@direct.bronsonhg.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ascension Borgess Allegan Hospital

  dba Ascension Borgess Allegan Hospital Outpatient Clinic

  • Multi-Specialty Clinic/Center
  • Allegan, MI
  • NPI 1144531252
  Medicare reassignment NPD
• Bronson Battle Creek Hospital

  dba Bronson Medical Group

  • Internal Medicine Physician
  • Battle Creek, MI
  • NPI 1093119638

  Nurse Practitioner

  Medicare reassignment NPD
• Bronson Methodist Hospital

  dba Bronson Medical Group

  • Hospitalist Physician
  • Kalamazoo, MI
  • NPI 1417961137
  Medicare reassignment NPD
• Bronson South Haven Hospital

  dba Bronson Medical Group

  • Family Medicine Physician
  • South Haven, MI
  • NPI 1174749170
  Medicare reassignment NPD
• West Michigan Cancer Center

  • Medical Oncology Physician
  • Kalamazoo, MI
  • NPI 1447261730

  Nurse Practitioner

  Medicare reassignment NPD
• Ascension Borgess Allegan Hospital

  dba Otsego Medical Center

  • Rural Health Clinic/Center
  • Otsego, MI
  • NPI 1750868493
  NPD
• Ascension Borgess Allegan Hospital

  • Hospitalist Physician
  • Allegan, MI
  • NPI 1992668925
  NPD
• Bronson Battle Creek Hospital

  dba Bronson Battle Creek Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Battle Creek, MI
  • NPI 1740351907
  NPD
• Bronson South Haven Hospital

  • General Acute Care Hospital
  • South Haven, MI
  • NPI 1346275856
  NPD
• West Michigan Cancer Center

  dba West Michigan Cancer Center Radiation Oncology

  • Radiation Oncology Physician
  • Kalamazoo, MI
  • NPI 1588778484

  Nurse Practitioner

  NPD

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1528035078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N PARK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490073731",
            "telephone_number": "269-382-2500",
            "fax_number": "269-373-7478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N PARK ST",
            "address_2": "WEST MICHIGAN CANCER CENTER",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490073731",
            "telephone_number": "269-382-2500",
            "fax_number": "269-373-7478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELLY",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-03",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704152480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4631966",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson HealthCare Group Direct Address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Isaac L Smith, HIS
• Jada Smith
• James Robert Smith, M.D.
• Jayla Smith, PHARMD
• Jessica Smith
• Kennidie Smith
• Kirstin Kay Smith, MSN, RN, ACCNS-P
• Kristen Smith, LLMSW
• Kristen Jane Smith, MA, ATC, EMT(B)
• Mindie Adele Smith, LPC

• Nurse Practitioner in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.