Kimberly K. Smith, CPNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71001976A Issued in IN

Practice address

8414 Naab Rd
Indianapolis, IN 46260-1972

Phone

(317) 338-7510

Fax

(317) 338-7515

NPI assigned

Apr 16, 2007

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 IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberly.smith.1@7598.direct.athenahealth.com

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.

• St Vincent Physician Services Hospital and Health Care Center

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1669422234

  Nurse Practitioner

  Medicare reassignment NPD
• St Vincent Physician Services Hospital and Health Care Center

  • Durable Medical Equipment & Medical Supplies
  • Carmel, IN
  • NPI 1366689044
  NPD
• Saint Vincent Physician Services, Inc.

  • Family Medicine Physician
  • Worcester, MA
  • NPI 1013997329

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1669697769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8414 NAAB RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8414 NAAB RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601972",
            "telephone_number": "317-338-7510",
            "fax_number": "317-338-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIMBERLY",
        "middle_name": "K.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001976A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200857130",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kimberly.smith.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "ST VINCENT PHYSICIAN SERVICES HOSPITAL AND HEALTH CARE CENTER",
            "address_1": "8414 Naab Rd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462601972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kenisha Smith
• Kenneth Lee Smith II, D.O.
• Kevin A Smith, MD
• Kevin L Smith, MD
• Kiara Smith, RBT
• Kimberly Nicole Williams Smith, DO
• Kinsey Smith, RBT
• Kora L Smith, OD
• Lalaine Yvonne Smith
• Landrey Smith

• Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.