Individual provider Active NPI

Kelli Gay Smith, AUD

  • Audiologist
  • Alpharetta, GA
National Provider Identifier
1831196203
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
3405 Issued in GA
Practice address
11770 Haynes Bridge Rd Ste 205-309
Alpharetta, GA 30009-1966
Phone
(833) 244-3275
Fax
(833) 244-3275
NPI assigned
Jun 30, 2005
Last updated
Sep 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 3405 GA Primary

Addresses

Primary practice location

11770 Haynes Bridge Rd Ste 205-309
Alpharetta, GA 30009-1966

Mailing address

11770 Haynes Bridge Rd Ste 205-309
Alpharetta, GA 30009-1966
Phone (833) 244-3275

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230818000462 GA Practitioner - Qualified Audiologist 8123021219 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3405GAMDAudiologist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1831196203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11770 HAYNES BRIDGE RD STE 205-309",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091966",
            "telephone_number": "833-244-3275",
            "fax_number": "833-244-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11770 HAYNES BRIDGE RD STE 205-309",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091966",
            "telephone_number": "833-244-3275",
            "fax_number": "833-244-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELLI",
        "middle_name": "GAY",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2022-09-27",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "GA",
            "license": "3405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.