Kathryn A. Smith, AUDIOLOGISTS

Primary specialty

AudiologistTaxonomy code 231H00000X

License

A3087 Issued in MS

Practice address

1605 S 28TH Ave
Hattiesburg, MS 39402-3110

Phone

(601) 579-3310

Fax

(601) 264-0231

NPI assigned

Dec 12, 2006

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

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Hearing and Balance LLCGroup PAC ID 5294050662, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ksmith20069@directpatientrecord.com

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.

• Advanced Hearing and Balance LLC

  • Audiologist
  • Hattiesburg, MS
  • NPI 1982025201
  Medicare reassignment Care Compare group NPD
• Hattiesburg Clinic PA

  • Multi-Specialty Clinic/Center
  • Hattiesburg, MS
  • NPI 1740213446
  Medicare reassignment NPD
• Hattiesburg Clinic, PA

  • Primary Care Clinic/Center
  • Flowood, MS
  • NPI 1912600354
  NPD
• Stewart Ear Nose and Throat Center

  • Medical Specialty Clinic/Center
  • Starkville, MS
  • NPI 1952462475
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1861553224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-579-3310",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023110",
            "telephone_number": "601-579-3310",
            "fax_number": "601-264-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATHRYN",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "AUDIOLOGISTS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MS",
            "license": "A3087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02086206",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9574868",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4656554",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "3151998",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksmith20069@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1605 S 28th Ave",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394023110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Felicia Nicole Smith, NP
• Heather E Smith
• Hunter K Smith
• James Matthew Smith, NP
• Johnnie J Smith
• Kimberly Tazamear Smith, RMA
• Lucy Diane Smith, MS CCC-SLP
• Megan Marie Smith, LMSW
• Melissa Carol Smith, FNP
• Melissa F Smith, PMHNP-BC

• Audiologist in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Audiologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.