Kim W Smith, NP C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

132460 Issued in NC

Practice address

5817 Tuckertown LN
Fayetteville, NC 28314-1375

Phone

(336) 339-1163

NPI assigned

Nov 2, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kim W Smith Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Haymount Institute for Psychological Services, PLLC

  • Clinical Psychologist
  • Fayetteville, NC
  • NPI 1437320892
  Medicare reassignment NPD
• Integrated Healthcare Solutions of NC LLC

  • Mental Health Counselor
  • Greensboro, NC
  • NPI 1174131213
  Medicare reassignment NPD
• Navi Care LLC

  • Non-emergency Medical Transport (VAN)
  • Greensboro, NC
  • NPI 1518762152
  Medicare reassignment NPD
• Positive Pathways LLC

  • Community/Behavioral Health Agency
  • Mayodan, NC
  • NPI 1629821681
  Medicare reassignment NPD
• Carter Clinic, P a

  • Psychiatry Physician
  • Raleigh, NC
  • NPI 1912959834
  Medicare reassignment
• Haymount Institute for Psychological Services, PLLC

  • Clinical Psychologist
  • Concord, NC
  • NPI 1316825656
  NPD
• Haymount Institute for Psychological Services, PLLC

  • Psychologist
  • Raeford, NC
  • NPI 1528239993
  NPD
• Randleman Family Clinic PLLC

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1912419078
  NPD
• Carter Clinic, P.a.

  • Psychiatry Physician
  • Kinston, NC
  • NPI 1982298261
  NPD (past)
• Carter Clinic, PA

  • Psychiatry Physician
  • Dunn, NC
  • NPI 1215461231
  NPD (past)

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386460800000",
    "number": "1811223464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5817 TUCKERTOWN LN",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141375",
            "telephone_number": "336-339-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5817 TUCKERTOWN LN",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141375",
            "telephone_number": "336-339-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIM",
        "middle_name": "W",
        "credential": "NP C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-02",
        "last_updated": "2013-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "132460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004844",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "SMITH",
            "middle_name": "W",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kendall Smith
• Kendall Spencer Smith, FNP
• Kendrick Smith
• Kenesha N Smith
• Kenneth Gregory Smith, LCSW
• Lindsay Smith, AU.D.
• Madeline Smith, AUD
• Madilyn Smith, PTA
• Madison Smith
• Malcolm Smith

• Family Nurse Practitioner in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.