Individual provider Active NPI

Kevin S Smith, MD

  • Internal Medicine Physician
  • Louisville, KY
National Provider Identifier
1619932993
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
39134 Issued in KY
Practice address
1930 Bishop LN
Ste 1017
Louisville, KY 40218-1921
Phone
(502) 272-5064
Fax
(502) 272-5339
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-082153 IL
Hospitalist Physician 208M00000X 39134 KY
Internal Medicine Physician 207R00000X 39134 KY Primary
Internal Medicine Physician 207R00000X 01051932A IN

Addresses

Primary practice location

1930 Bishop LN
Ste 1017
Louisville, KY 40218-1921

Mailing address

PO Box 950202
Louisville, KY 40295-0202
Phone (502) 588-9490

Other practice location 1

200 Abraham Flexner Way
Louisville, KY 40202-2877
Phone (502) 587-4267

Other identifiers 8

IdentifierTypeStateIssuer
214881OtherILMEDICARE GROUP PTAN
P00267326OtherKYRAILROAD MEDICARE - NICC
P00838098OtherINRAILROAD MEDICARE - NICC
64094048MedicaidKY
049238OtherSIHO
200156690MedicaidIN
P00272398OtherKYRAILROAD MEDICARE - NICC
000000382064OtherANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041028000185 KY Practitioner - Internal Medicine 2163484635 Reassigns benefits to 4 organizations
I20130827000142 IL Practitioner - Internal Medicine 2163484635 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Southern Illinois University School of Medicine, 1988
Medicare assignment
May accept Medicare assignment
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians
Cleanslate Medical Group of Kentucky PLLCGroup PAC ID 4486909769, 18 clinicians

Practice addresses (Care Compare)

1 Audubon Plaza Dr
Louisville, KY 40217-1318
Phone (502) 636-7225

4001 Dutchmans LN
Louisville, KY 40207-4714
Phone (502) 893-1270

6801 Dixie Hwy
Suite 132
Louisville, KY 40258-3952
Phone (502) 657-2701

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-082153ILMDInternal Medicine Physician
01051932AINMDInternal Medicine Physician
39134KYMDInternal Medicine Physician
TP518KYMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Sep 11, 2024 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Jun 1, 2013 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Jan 1, 2005 Accepting new patients
University of Louisville Physicians Inc. Internal Medicine CurrentSince Sep 11, 2024 Accepting new patients
Sound Physicians of Illinois, LLC Internal Medicine CurrentSince Sep 1, 2015 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Cleanslate Medical Group of Kentucky PLLC CurrentSince May 1, 2024 Accepting new patients
University of Louisville Physicians, Inc. Internal Medicine Current Accepting new patients
Hospital Medicine Services of Ky, LLC Hospitalist CurrentSince Apr 1, 2023 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jun 1, 2013 Accepting new patients
Norton Enterprises, Inc. Past Accepting new patients
Community Medical Associates, Inc. Past Accepting new patients
Community Medical Associates, Inc. Internal Medicine Past Accepting new patients
Total Wellness Centers, LLC Past Accepting new patients

Locations

135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

7752 Solution Ctr
Chicago, IL 60677

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

1300 Franklin Ave
Ste 380
Normal, IL 61761
Phone (309) 268-3589

1304 Franklin Ave
Normal, IL 61761
Phone (309) 268-3590

1600 W Walnut St
South Jacksonville, IL 62650
Phone (217) 245-7275

2051 Clevidence Blvd
Clarksville, IN 47129
Phone (812) 280-6650

1232 Adams St
Ste 200
Bowling Green, KY 42101
Phone (270) 467-7180

1801 Ashley Cir
Bowling Green, KY 42104
Phone (270) 781-4330

299 Kings Daughters Dr
Hatton, KY 40601
Phone (502) 875-5240

1500 Leestown Rd
Ste 110
Lexington, KY 40511
Phone (502) 657-2701

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

200 Abraham Flexner Way
Louisville, KY 40202
Phone (502) 569-7983

6801 Dixie Hwy
Ste 132
Louisville, KY 40258
Phone (502) 657-2701

7926 Preston Hwy
Louisville, KY 40219
Phone (502) 964-4357

200 E Chestnut St
Ste 303
Louisville, KY 40202
Phone (502) 629-5552

210 E Gray St
Ste 803
Louisville, KY 40202
Phone (502) 582-6900

1930 Bishop Ln
Ste 1017
Louisville, KY 40218
Phone (502) 272-5064

10284 Shelbyville Rd
Louisville, KY 40223
Phone (502) 244-5827

3500 Villa Pt
Ste 110A
Owensboro, KY 42303

59 Bobala Rd
Holyoke, MA 01040
Phone (413) 486-7819

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1619932993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950202",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 BISHOP LN",
            "address_2": "STE 1017",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402181921",
            "telephone_number": "502-272-5064",
            "fax_number": "502-272-5339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Abraham Flexner Way",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402022877",
            "country_code": "US",
            "telephone_number": "502-587-4267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KEVIN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-082153",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "39134",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "39134",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01051932A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "214881",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE - NICC",
            "identifier": "P00267326",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE - NICC",
            "identifier": "P00838098",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64094048",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO",
            "identifier": "049238",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200156690",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE - NICC",
            "identifier": "P00272398",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000382064",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.