Individual provider Active NPI

Kody Jacob Smitherman, FNP

  • Family Nurse Practitioner
  • Maryville, TN
National Provider Identifier
1811643844
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
31220 Issued in TN
Practice address
1012 Jamestown Way
Maryville, TN 37803-5865
Phone
(872) 231-3162
NPI assigned
Feb 28, 2022
Last updated
Oct 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 31220 TN Primary

Addresses

Primary practice location

1012 Jamestown Way
Maryville, TN 37803-5865

Mailing address

PO Box 74008272
Chicago, IL 60674-8272
Phone (702) 899-0595

Other practice location 1

907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015
Phone (865) 980-5100

Other identifiers 1

IdentifierTypeStateIssuer
Q075216MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20220727000752 TN Practitioner - Nurse Practitioner 5496137259 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Rehab Consultants LLCGroup PAC ID 7810184892, 162 clinicians
Blount Memorial Physician Group IncGroup PAC ID 6406844174, 252 clinicians

Practice addresses (Care Compare)

2648 Sevierville Rd
Maryville, TN 37804-3643
Phone (312) 635-0973

405 BMH Physicians Office BLDG
Maryville, TN 37804-5807
Phone (865) 238-6430

425 BMH Physicians
Office BLDG
Maryville, TN 37804-5807
Phone (865) 980-5260

463 BMH Physician
Office BLDG
Maryville, TN 37804-5807
Phone (865) 980-5100

907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015
Phone (864) 455-3748

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.77 of 100Reported as group
Quality
58.61
Promoting interoperability
92
Improvement activities
40
Cost
73.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31220TNMDCritical Care Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehab Consultants LLC CurrentSince Sep 22, 2025 Accepting new patients
Integrated Rehab Consultants LLC CurrentSince Sep 22, 2025 Accepting new patients
Blount Memorial Physician Group, Inc CurrentSince Jul 18, 2022 Accepting new patients

Locations

266 Joule St
Alcoa, TN 37701
Phone (865) 984-3864

1012 Jamestown Way
Maryville, TN 37803
Phone (865) 984-7400

103 W Broadway Ave
Maryville, TN 37801

2648 Sevierville Rd
Maryville, TN 37804
Phone (865) 984-1660

307 N 5th St
Maryville, TN 37804
Phone (423) 983-0261

463 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 980-5100

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

8353 Highway 100
Nashville, TN 37221
Phone (629) 888-5539

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: ksmitherman864468@direct.ghs.myhfn.org

Organizations & group practices 3

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": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1811643844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74008272",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606748272",
            "telephone_number": "702-899-0595",
            "fax_number": "702-977-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 JAMESTOWN WAY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378035865",
            "telephone_number": "872-231-3162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "907 E Lamar Alexander Pkwy",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "TN",
            "postal_code": "378045015",
            "country_code": "US",
            "telephone_number": "865-980-5100",
            "fax_number": "865-980-5105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITHERMAN",
        "first_name": "KODY",
        "middle_name": "JACOB",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-28",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "31220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q075216",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

Verify at the official NPI Registry.