Active NPI
Kayla Smith
- Clinical Social Worker
- Mayo, FL
National Provider Identifier
1689333866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW16722
- Practice address
- 512 W Main St
Mayo, FL 32066-4136 - Phone
- (850) 843-2339
- NPI assigned
- Dec 15, 2021
- Last updated
- Dec 28, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ISW16722 | FL | Primary |
Addresses
Primary practice location
512 W Main St
Mayo, FL 32066-4136
Mailing address
2839 Bernard Johnson Rd
Perry, FL 32347-8827
Phone (850) 843-2339
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211229000131 | FL | Practitioner - Clinical Social Worker | 4486045507 | Practice locations: Cross City, FL; Madison, FL; Mayo, FL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640649600000",
"number": "1689333866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2839 BERNARD JOHNSON RD",
"city": "PERRY",
"state": "FL",
"postal_code": "323478827",
"telephone_number": "850-843-2339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "512 W MAIN ST",
"city": "MAYO",
"state": "FL",
"postal_code": "320664136",
"telephone_number": "850-843-2339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "KAYLA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-15",
"last_updated": "2021-12-28",
"certification_date": "2021-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "ISW16722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mayo, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; 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.