Individual provider Active NPI

Kristie A Smith, NP

  • Family Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1700339249
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704283860 Issued in MI
Practice address
880 SW 145TH Ave Ste 202
Pembroke Pines, FL 33027-6171
Phone
(866) 849-0692
NPI assigned
Aug 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1217055 TX
Family Nurse Practitioner 363LF0000X 4704283860 MI Primary
Family Nurse Practitioner 363LF0000X LG-0013583 DE
Family Nurse Practitioner 363LF0000X 14260030-4405 UT
Family Nurse Practitioner 363LF0000X 333686 AZ
Family Nurse Practitioner 363LF0000X 31327 SC
Family Nurse Practitioner 363LF0000X 4053505 KY
Family Nurse Practitioner 363LF0000X 70097071 WA
Family Nurse Practitioner 363LF0000X APN.1001791-NP CO
Family Nurse Practitioner 363LF0000X A189806 IA
Family Nurse Practitioner 363LF0000X APRN11043683 FL

Addresses

Primary practice location

880 SW 145TH Ave Ste 202
Pembroke Pines, FL 33027-6171

Mailing address

PO Box 211699
Eagan, MN 55121-3699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20160916000113 MI Practitioner - Nurse Practitioner 8426344599 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
333686AZMDFamily Nurse Practitioner
LG-0013583DEMDFamily Nurse Practitioner
APRN11043683FLMDFamily Nurse Practitioner
A189806IAMDFamily Nurse Practitioner
4053505KYMDFamily Nurse Practitioner
4704283860MIMDFamily Nurse Practitioner
31327SCMDFamily Nurse Practitioner
1217055TXMDFamily Nurse Practitioner
14260030-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deckerville Community Hospital, Inc CurrentSince May 1, 2024 Accepting new patients
Hills & Dales General Hospital, Inc. CurrentSince Feb 2, 2019 Accepting new patients
Hills & Dales General Hospital, Inc. CurrentSince Feb 2, 2019 Accepting new patients
Marlette Regional Hospital Current Accepting new patients
Deckerville Community Hospital Inc CurrentSince May 1, 2024 Accepting new patients
Deckerville Community Hospital, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Deckerville Community Hospital, Inc. Current Accepting new patients

Locations

4675 Hill St
Ste B
Cass City, MI 48726
Phone (989) 912-6112

4675 Hill St
Cass City, MI 48726
Phone (989) 872-2121

3559 Pine St
Deckerville, MI 48427
Phone (810) 376-2835

Interoperability endpoints

  • Direct secure messaging: ksmith74564@direct.covenanthealthcare.com

Organizations & group practices 7

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": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1700339249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211699",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551213699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 SW 145TH AVE STE 202",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330276171",
            "telephone_number": "866-849-0692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRISTIE",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1217055",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704283860",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0013583",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "14260030-4405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "333686",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "31327",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4053505",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "70097071",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.1001791-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A189806",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11043683",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.