Active NPI
Mary Kathryn Smith
- Clinical Social Worker
- Mountain Home, TN
National Provider Identifier
1831766260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 8617
- Practice address
- Lamont Street & Veterans Way
Mountain Home, TN 37684-4000 - Phone
- (423) 926-1171
- NPI assigned
- Jun 4, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 8617 | TN | Primary |
Addresses
Primary practice location
Lamont Street & Veterans Way
Mountain Home, TN 37684-4000
Mailing address
PO Box 4000
Mountain Home, TN 37684-4000
Phone (423) 926-1171
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- East Tennessee State University Quillen College of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
400 Balsam Dr
Knoxville, TN 37918-3001
Phone (323) 205-7088
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8617 | TN | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Specialty Group PA | Current | Accepting new patients |
Organizations & group practices 2
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": "1622764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700006400000",
"number": "1831766260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4000",
"city": "MOUNTAIN HOME",
"state": "TN",
"postal_code": "376844000",
"telephone_number": "423-926-1171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "LAMONT STREET & VETERANS WAY",
"city": "MOUNTAIN HOME",
"state": "TN",
"postal_code": "376844000",
"telephone_number": "423-926-1171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "MARY",
"middle_name": "KATHRYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-04",
"last_updated": "2023-11-15",
"certification_date": "2023-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "8617",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain Home, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.