Kimberly Smith

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

5030 78TH Ave N Ste 11
Pinellas Park, FL 33781-2406

Phone

(727) 545-1273

Fax

(800) 713-8330

NPI assigned

Feb 21, 2017

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

Other names 1

• Kimberly Marie Smith Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1639618879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2098 SEMINOLE BLVD APT 3408",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337781724",
            "telephone_number": "727-772-3927",
            "fax_number": "800-713-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 78TH AVE N STE 11",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337812406",
            "telephone_number": "727-545-1273",
            "fax_number": "800-713-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-21",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "SMITH",
            "middle_name": "MARIE",
            "credential": "BCBA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sherman Coplan Slone, PSY.D., ABPP
• Mollie Sluss, LCSW
• Brittany Smith, PA-C
• Kamyia Smith, RBT
• Karmen Smith, LMHC, CRC
• Tamala D Smith
• Tameika Antoinette Smith, RN
• Yana Smith
• Charlene Ann Snell, OTR/L
• Robert V Snyders Jr., DMD

• Behavior Analyst in Pinellas Park, FL
• Providers in Pinellas Park, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.