Individual provider Active NPI

Katherine Smalley, PA-C

  • Physician Assistant
  • Meridian, ID
National Provider Identifier
1750863122
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3253 Issued in SC
Practice address
1618 S Millenium Way Ste 100
Meridian, ID 83642-6457
Phone
(208) 884-3376
Fax
(208) 884-0858
NPI assigned
Sep 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3253 SC Primary

Addresses

Primary practice location

1618 S Millenium Way Ste 100
Meridian, ID 83642-6457

Mailing address

169 Ashley Avenue
2ND Floor Main Hopsital H268
Charleston, SC 29425-8905
Phone (843) 792-7097

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190326000805 ID Practitioner - Physician Assistant 8325388580 Reassigns benefits to 1 organization
I20190812002492 SC Practitioner - Physician Assistant 8325388580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
77.64 of 100Reported as group
Quality
70.07
Promoting interoperability
100
Improvement activities
40
Cost
55.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3253SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Physician Assistant CurrentSince Jun 13, 2019 Accepting new patients
University Medical Associates of the Medical University of South Carol Physician Assistant CurrentSince Jun 13, 2019 Accepting new patients

Locations

169 Ashley Ave
Fl 2
Charleston, SC 29425

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Interoperability endpoints

  • Direct secure messaging: ksmalley@adawest.emadirect.md

Organizations & group practices 4

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": "1535932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1750863122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVENUE",
            "address_2": "2ND FLOOR MAIN HOPSITAL H268",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-792-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 S MILLENIUM WAY STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426457",
            "telephone_number": "208-884-3376",
            "fax_number": "208-884-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLEY",
        "first_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-03",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "169 Ashley Ave",
            "address_2": "2nd floor main hospital, H268",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294258905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.