Kelly M Smart, P.A

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1125 Issued in TN

Practice address

141 Hillcrest Dr
Clarksville, TN 37043

Phone

(931) 552-4340

Fax

(931) 552-0999

NPI assigned

May 24, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Merit-based Incentive Payment System (MIPS)

Final score

81.78 of 100Reported as group

Quality

65.3

Promoting interoperability

96

Improvement activities

40

Cost

77.31

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.smart.p1@direct.toa.nextgenshare.com

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.

• Tennessee Orthopaedic Alliance PA

  • Orthopaedic Surgery Physician
  • Nashville, TN
  • NPI 1538153937
  Medicare reassignment
• Seven Springs and Sports Medicine

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Lawrenceburg, TN
  • NPI 1215320650
  NPD
• Tennessee Orthopaedic Alliance PA

  • Multi-Specialty Clinic/Center
  • Clarksville, TN
  • NPI 1336905561
  NPD
• Tennessee Orthopaedic Alliance PA

  • Orthopaedic Surgery Physician
  • Oak Ridge, TN
  • NPI 1851988513
  NPD
• Advanced Diagnostic Imaging PC

  • Durable Medical Equipment & Medical Supplies
  • Lewisburg, TN
  • NPI 1922846559
  NPD (past)
• Tennessee Orthopaedic Alliance PA

  • Orthopaedic Surgery Physician
  • Smyrna, TN
  • NPI 1205820610
  NPD (past)
• The Joint and Spine Pain Center

  • Pain Medicine Physician
  • Clarksville, TN
  • NPI 1154386282
  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1720081532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 NORRIS AVE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37204",
            "telephone_number": "615-695-1407",
            "fax_number": "615-695-1483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 HILLCREST DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37043",
            "telephone_number": "931-552-4340",
            "fax_number": "931-552-0999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Ted A Crozier Blvd",
            "address_2": "SUITE A",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370438912",
            "country_code": "US",
            "telephone_number": "931-802-6100",
            "fax_number": "931-802-6077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMART",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA1125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620862316",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3663312",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY MEDICAID",
            "identifier": "9500536900",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "work",
            "affiliation": "N",
            "address_1": "141 Hillcrest Dr",
            "city": "Clarksville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370435088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sleep Professionals, LLC
• Sleep Unlimited Clarksville
• Jacob Matthew Slight
• Beth Slusser
• Jovan Marcel Smallwood
• Alexandra Childs Smith, PSY.D.
• Alexis Smith, COTA/L
• Angela Jeanne Smith, LPN
• Autumn B Smith, PT
• Barbara Ellen Smith, PA

• Physician Assistant in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.