Individual provider Active NPI

Karem P Smith

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1710322912
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
105577 Issued in CA
Practice address
11838 Bernardo Plaza CT Ste 250
San Diego, CA 92128-2434
Phone
(858) 380-2600
NPI assigned
May 2, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 105577 CA Primary

Addresses

Primary practice location

11838 Bernardo Plaza CT Ste 250
San Diego, CA 92128-2434

Mailing address

11838 Bernardo Plaza CT Ste 250
San Diego, CA 92128-2434
Phone (858) 380-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20260518002308 CA Practitioner - Marriage and Family Therapist 7719456847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105577CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Marvin Behavioral Health Ma PC Marriage & Family Therapist Past Accepting new patients
Reproductive Mental Health and Wellness Licensed Clinical Social Worke PastSince Jun 14, 2020 Accepting new patients

Organizations & group practices 3

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": "1367452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1710322912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11838 BERNARDO PLAZA CT STE 250",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282434",
            "telephone_number": "858-380-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11838 BERNARDO PLAZA CT STE 250",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282434",
            "telephone_number": "858-380-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KAREM",
        "middle_name": "P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-02",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "105577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.