Individual provider Active NPI

Kimberly Kay Smoot, FNP

  • Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1801308242
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5019590 Issued in NC
Practice address
3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone
(336) 718-7041
Fax
(336) 718-9622
NPI assigned
Oct 25, 2017
Last updated
Aug 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5019590 NC Primary
Family Nurse Practitioner 363LF0000X 5019590 NC
Family Nurse Practitioner 363LF0000X 21252 SC

Addresses

Primary practice location

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 718-7041

Other practice location 1

316 Calhoun St
Charleston, SC 29401-1113
Phone (843) 606-7810

Other identifiers 1

IdentifierTypeStateIssuer
NP5628MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 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
I20190201000185 SC Practitioner - Nurse Practitioner 2062759822 Reassigns benefits to 1 organization
I20240219000402 NC Practitioner - Nurse Practitioner 2062759822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-7597

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network Current Accepting new patients
Family Health Centers, Inc Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 8, 2024 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Oct 26, 2020 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 8, 2024 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Oct 26, 2020 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

1750 Kernersville Medical Pkwy
Kernersville, NC 27284
Phone (336) 564-4000

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

922 Holly St
Holly Hill, SC 29059
Phone (803) 496-7174

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

3310 Magnolia St
Orangeburg, SC 29115
Phone (803) 531-6900

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFEFCD
  • Direct secure messaging: ksmoot1261228@direct.novanthealth.org

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1801308242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-718-7041",
            "fax_number": "336-718-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SILAS CREEK PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "telephone_number": "336-718-7041",
            "fax_number": "336-718-9622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "316 Calhoun St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294011113",
            "country_code": "US",
            "telephone_number": "843-606-7810",
            "fax_number": "843-606-8088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMOOT",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-25",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5019590",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5019590",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "21252",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP5628",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.