Individual provider Active NPI

Kimberly Denise Smalls

  • Nurse's Aide
  • Goose Creek, SC
National Provider Identifier
1700628906
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
139836 Issued in SC
Practice address
221 Saint James Ave
Goose Creek, SC 29445-2976
Phone
(843) 377-8637
NPI assigned
Jun 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 139836 SC Primary

Addresses

Primary practice location

221 Saint James Ave
Goose Creek, SC 29445-2976

Mailing address

221 Saint James Ave
Goose Creek, SC 29445-2976
Phone (843) 377-8637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
139836SCMDNurse's Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Untouchable Hands Home Care LLC Current Accepting new patients

Organizations & group practices 1

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": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1700628906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 SAINT JAMES AVE",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294452976",
            "telephone_number": "843-377-8637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 SAINT JAMES AVE",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294452976",
            "telephone_number": "843-377-8637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLS",
        "first_name": "KIMBERLY",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "SC",
            "license": "139836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goose Creek, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.