Kimberly A Smallwood, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

91402 Issued in OK

Practice address

2617 S Elm PL
Broken Arrow, OK 74012

Phone

(918) 455-4541

Fax

(918) 455-0414

NPI assigned

Oct 17, 2017

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

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Home Health of Northeast Oklahoma Home health agency, Broken Arrow, OK, CCN 377572
• Hillcrest Hospital South Hospital, Tulsa, OK, CCN 370202
• Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001
• Saint Francis Hospital South, LLC Hospital, Tulsa, OK, CCN 370218

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ksmallwood113222@ahs.direct-ci.com
• FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

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.

• Ahs Oklahoma Physician Group LLC

  dba Utica Park Clinic

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1235182775

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Ahs Oklahoma Physician Group, LLC

  dba Cushing Medical Specialist

  • Rural Health Clinic/Center
  • Cushing, OK
  • NPI 1922683051
  NPD

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

• Ahs Hillcrest Medical Center, LLC

  dba Hillcrest Medical Center

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1629057229
  Care Compare affiliation
• Ahs Southcrest Hospital, LLC

  dba HIllcrest Hospital South

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1750661534
  Care Compare affiliation
• Day-by-Day Staff Relief, LLC

  dba Enhabit Home Health of Northeast Oklahoma

  • Home Health Agency
  • Broken Arrow, OK
  • NPI 1407836760
  Care Compare affiliation
• Saint Francis Hospital South LLC

  dba Saint Francis Hospital South

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1376561944
  Care Compare affiliation

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1538670690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 S ELM PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740127850",
            "telephone_number": "918-455-4541",
            "fax_number": "918-455-0414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 S ELM PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "74012",
            "telephone_number": "918-455-4541",
            "fax_number": "918-455-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLWOOD",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-17",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "91402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200739390A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Alexis Smith
• Ashlee Nicole Smith
• Ashley Michelle Smith, DPT
• Bianca Smith
• Brittany Naomi Smith, APRN-BC

• Nurse Practitioner in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.