Kynesha Smith, LISW-CP

Primary specialty

Social WorkerTaxonomy code 104100000X

License

15703 Issued in SC

Practice address

7901 4TH St N Ste 4000
St Petersburg, FL 33702-4305

Phone

(404) 981-5004

NPI assigned

Nov 24, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, OH, SC, TX4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 4

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Master of Science

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kyneshasmith@tdh.allscriptsdirect.net

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  DC, OH, SC, TX

  Medicare reassignment
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567
  NPD

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

{
    "created_epoch": "1669248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1609586155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 248",
            "city": "MAYESVILLE",
            "state": "SC",
            "postal_code": "291040248",
            "telephone_number": "404-981-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 4TH ST N STE 4000",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337024305",
            "telephone_number": "404-981-5004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "136 Forum Dr Ste 4",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292297980",
            "country_code": "US",
            "telephone_number": "706-928-6260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KYNESHA",
        "credential": "LISW-CP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-24",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "13386",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "15703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Leigh Smith
• Joshua Ryan Smith, DC
• Karen Smith
• Kaymeron Smith
• Kerrin R Smith, RPH
• Larissa Smith, AP, DOM
• Lauren Rachelle Smith, LCSW
• Matthew Gregory Smith, M.D.
• Megan Smith
• Melanie Ann Smith, AP

• Social Worker in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.