Individual provider Active NPI

Katherine Joan Smith, ARNP

  • Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1811978026
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP2701012 Issued in FL
Practice address
60 W Gore St
Orlando, FL 32806-1141
Phone
(407) 423-1039
Fax
(407) 425-2347
NPI assigned
Nov 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP2701012 FL Primary

Addresses

Primary practice location

60 W Gore St
Orlando, FL 32806-1141

Mailing address

60 W Gore St
Orlando, FL 32806-1141
Phone (407) 423-1039

Other identifiers 1

IdentifierTypeStateIssuer
306617700MedicaidFL

Other names 1

  • Kathy Joan Smith Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100811000926 FL Practitioner - Nurse Practitioner 7719011857 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Dec 1, 2011 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Dec 1, 2011 Accepting new patients
Florida Infectious Disease Group PA Past Accepting new patients
Infectious Diseases Orlando PA. PastSince May 19, 2024 Accepting new patients

Locations

60 W Gore St
Orlando, FL 32806
Phone (321) 841-3338

1414 Kuhl Ave
Orlando, FL 32806
Phone (407) 464-9516

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

9430 Turkey Lake Rd
Ste 108
Orlando, FL 32819
Phone (407) 237-6377

9400 Turkey Lake Rd
Orlando, FL 32819
Phone (321) 843-5500

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1811978026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 W GORE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061141",
            "telephone_number": "407-423-1039",
            "fax_number": "407-425-2347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 W GORE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061141",
            "telephone_number": "407-423-1039",
            "fax_number": "407-425-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATHERINE",
        "middle_name": "JOAN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2701012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306617700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "SMITH",
            "middle_name": "JOAN",
            "credential": "ARNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.