Kimberly Ruth Smith, DVM

Primary specialty

Prevention ProfessionalTaxonomy code 405300000X

License

24006744A Issued in IN

Practice address

5902 Homestead Rd
Fort Wayne, IN 46814-4202

Phone

(260) 434-0207

Fax

(260) 432-6448

NPI assigned

May 26, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Indian Creek Veterinary Hospital

  • Public Health or Welfare Agency
  • Fort Wayne, IN
  • NPI 1891383824
  NPD

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1821663378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5902 HOMESTEAD RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468144202",
            "telephone_number": "260-434-0207",
            "fax_number": "260-432-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5902 HOMESTEAD RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468144202",
            "telephone_number": "260-434-0207",
            "fax_number": "260-432-6448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIMBERLY",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "DVM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "IN",
            "license": "24006744A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth A Smith, MD
• Kerrigan C Smith
• Kiarra Smith
• Kim Marie Smith, LCSW, LMFT
• Kimberly K Smith, M ED
• Linda C Smith, LMFT LMHC
• Lisa Ann Smith, MSN, RN, AGCNS, NP-C
• Mareah Smith, RBT
• Melinda Elise Smith, L.M.T. , M.M.P
• Melissa Nicole Smith, MSN, FNP

• Prevention Professional in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Prevention Professional in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.