Sandra Doreen Smith-Kirby, AGNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

5010887 Issued in NC

Practice address

3504 Langston Blvd
Winterville, NC 28590-9314

Phone

(252) 258-2370

Fax

(252) 752-8555

NPI assigned

Mar 29, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eastern Nephrology Associates PLLCGroup PAC ID 2264420512, 75 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vidant Roanoke Chowan Hospital Hospital, Ahoskie, NC, CCN 340099
• Ecu Health Bertie Hospital Hospital, Windsor, NC, CCN 341304

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssmithkirby22367@direct.acumenmd.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eastern Nephrology Associates PLLC

  • Nephrology Physician
  • Greenville, NC
  • NPI 1417083783

  Multi-Specialty

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• East Carolina Health

  dba ECU Health Roanoke-Chowan Hospital

  • General Acute Care Hospital
  • Ahoskie, NC
  • NPI 1467441394
  Care Compare affiliation
• East Carolina Health-Bertie

  dba ECU Health Bertie Hospital

  • Critical Access Hospital
  • Windsor, NC
  • NPI 1013999705
  Care Compare affiliation

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1740785799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3504 LANGSTON BLVD",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285909314",
            "telephone_number": "252-258-2370",
            "fax_number": "252-752-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3504 LANGSTON BLVD",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285909314",
            "telephone_number": "252-258-2370",
            "fax_number": "252-752-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-KIRBY",
        "first_name": "SANDRA",
        "middle_name": "DOREEN",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "5010887",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5010887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Neverte Sidrak, PHARM D.
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• Smeg Family Mental Health
• Lawquara T Smith
• Natisha Angienik Smith, CSAC
• Tonya Ramona Smith, LCAS-A
• Solace Springs Counseling PLLC
• Yolanda Roshel Soney, LCSW

• Gerontology Nurse Practitioner in Winterville, NC
• Providers in Winterville, NC by specialty
• Gerontology Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; 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.