NPIMap

Individual provider Active NPI

Kirby Odis Smith, D.O.

  • Family Medicine Physician
  • Moultrie, GA
National Provider Identifier
1801987292
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
039676 Issued in GA
Practice address
3131 S Main St
Moultrie, GA 31768-6925
Phone
(229) 502-9769
Fax
(229) 985-3751
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 039676 GA Primary

Addresses

Primary practice location

3131 S Main St
Moultrie, GA 31768-6925

Mailing address

PO Box 2876
Moultrie, GA 31776-2876
Phone (229) 502-9769

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101119000653 GA Practitioner - Family Practice 5799830758 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Nova Southeastern College of Osteo Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
Colquitt Regional Medical CenterGroup PAC ID 6204821796, 20 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

3131 S Main St
Moultrie, GA 31768-6925
Phone (229) 502-9769

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Phoebe Physician Group, Inc CurrentSince Dec 1, 2012 Accepting new patients
Colquitt Regional Medical Center CurrentSince Jul 1, 2016 Accepting new patients
Phoebe Dorminy Surgical Associates CurrentSince Dec 1, 2012 Accepting new patients
Colquitt Regional Medical Center CurrentSince Jul 1, 2016 Accepting new patients
Colquitt Regional Medical Center Family Medicine CurrentSince Jul 25, 2019 Accepting new patients
Colquitt Regional Medical Center Family Medicine Past Accepting new patients

Locations

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

760 26th Ave SE
Moultrie, GA 31768
Phone (229) 502-9710

3131 Thomasville Hwy
Moultrie, GA 31768
Phone (229) 502-9769

9 Hospital Park
Moultrie, GA 31768
Phone (229) 890-1442

6 Hospital Park
Moultrie, GA 31768
Phone (229) 891-9009

1 Magnolia Ct
Moultrie, GA 31768
Phone (229) 502-9753

Interoperability endpoints

  • Direct secure messaging: ksmith@crmg.gwaydirect.com

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1801987292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2876",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317762876",
            "telephone_number": "229-502-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 S MAIN ST",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317686925",
            "telephone_number": "229-502-9769",
            "fax_number": "229-985-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIRBY",
        "middle_name": "ODIS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "039676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moultrie, GA

Sources for this page

Verify at the official NPI Registry.