Individual provider Active NPI

Kimberly Smith

  • Professional Counselor
  • Dothan, AL
National Provider Identifier
1699235440
Registry record updated Mar 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4056 Issued in AL
Practice address
1672 Columbia Hwy
Dothan, AL 36303-5434
Phone
(334) 712-2673
NPI assigned
Mar 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4056 AL Primary

Addresses

Primary practice location

1672 Columbia Hwy
Dothan, AL 36303-5434

Mailing address

1672 Columbia Hwy
Dothan, AL 36303-5434
Phone (334) 712-2673

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Kims@spectracare.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240126000484 AL Practitioner - Mental Health Counselor 8426401472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectracare Health Systems IncGroup PAC ID 3779509765, 15 clinicians

Practice addresses (Care Compare)

3542 Montgomery Hwy
Dothan, AL 36303-2165
Phone (334) 712-2720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4056ALMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Spectracare Integrated Services LLC CurrentSince Jan 1, 2024 Accepting new patients
Spectracare Health Systems, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

219 Dothan Rd
Abbeville, AL 36310
Phone (334) 585-5331

1242 US Highway 431 S
Abbeville, AL 36310
Phone (334) 585-6864

134 Prevatt Rd
Dothan, AL 36301
Phone (334) 699-3858

1672 Columbia Hwy
Dothan, AL 36303
Phone (334) 712-2671

3542 Montgomery Hwy
Dothan, AL 36303
Phone (334) 712-2720

440 Honeysuckle Rd
Dothan, AL 36305
Phone (334) 673-2143

133 N Orange Ave
Eufaula, AL 36027

1203 W Maple Ave
Geneva, AL 36340
Phone (334) 805-1395

134 Katherine Ave
Ozark, AL 36360
Phone (334) 774-5146

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/spectracare/r4/
  • Direct secure messaging: kims@spectracare.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1699235440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1672 COLUMBIA HWY",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363035434",
            "telephone_number": "334-712-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1672 COLUMBIA HWY",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363035434",
            "telephone_number": "334-712-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "4056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kims@spectracare.org",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1672 Columbia Hwy",
            "city": "Dothan",
            "state": "AL",
            "country_code": "US",
            "postal_code": "363035434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.