Individual provider Active NPI

Kimberly Nicole Williams Smith, DO

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1841617701
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02005114A Issued in IN
Practice address
8414 Naab Rd
Indianapolis, IN 46260-1972
Phone
(317) 338-7510
NPI assigned
Mar 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02005114A IN Primary

Addresses

Primary practice location

8414 Naab Rd
Indianapolis, IN 46260-1972

Mailing address

8414 Naab Rd
Indianapolis, IN 46260-1972

Other practice location 1

8414 Naab Rd Ste 135
Indianapolis, IN 46260-1972
Phone (317) 338-7760

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kimberly.smith.2@7598.direct.athenahealth.com ST VINCENT PHYSICIAN SERVICES HOSPITAL AND HEALTH CARE CENTER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170816002562 IN Practitioner - Family Practice 4789805219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8414 Naab Rd
Indianapolis, IN 46260-1972
Phone (317) 338-7510

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Physician Services Hospital and Health Care Center Family Medicine CurrentSince Aug 7, 2017 Accepting new patients
St Vincent Physician Services Hospital and Health Care Center CurrentSince Aug 7, 2017 Accepting new patients
Saint Vincent Physician Services, Inc. Family Medicine Past Accepting new patients

Locations

8240 Naab Rd
Ste 155
Indianapolis, IN 46260
Phone (317) 338-7760

8414 Naab Rd
Ste 135
Indianapolis, IN 46260
Phone (317) 338-7760

8414 Naab Rd
Indianapolis, IN 46260
Phone (317) 338-1600

8240 Naab Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 338-7450

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1841617701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8414 NAAB RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8414 NAAB RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601972",
            "telephone_number": "317-338-7510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8414 Naab Rd Ste 135",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462601972",
            "country_code": "US",
            "telephone_number": "317-338-7760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIMBERLY",
        "middle_name": "NICOLE WILLIAMS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-27",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02005114A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kimberly.smith.2@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "ST VINCENT PHYSICIAN SERVICES HOSPITAL AND HEALTH CARE CENTER",
            "address_1": "8414 Naab Rd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462601972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.