Kimberly Jo Smith, LISW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

099698 Issued in IA

Practice address

320 N Eisenhower Ave
Mason City, IA 50401-1521

Phone

(641) 424-2391

Fax

(641) 424-0783

NPI assigned

Oct 29, 2019

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

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Prairie Ridge Integrated Behavioral HealthcareGroup PAC ID 6800169194, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Prairie Ridge Integrated Behavioral Healthcare

  • Substance Abuse Rehabilitation Facility
  • Mason City, IA
  • NPI 1952443632

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD
• Prairie Ridge Integrated Behavioral Healthcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mason City, IA
  • NPI 1801637061
  NPD

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1881238244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 W MAIN ST",
            "city": "FERTILE",
            "state": "IA",
            "postal_code": "504341031",
            "telephone_number": "641-529-2165",
            "fax_number": "641-424-0783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 N EISENHOWER AVE",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504011521",
            "telephone_number": "641-424-2391",
            "fax_number": "641-424-0783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIMBERLY",
        "middle_name": "JO",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "099698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Satinderjit Singh, M.D.
• Audrey Rayal Skjeie
• David Christian Sloan, M.D.
• Smile Doctors of Iowa PC
• Heidi Smith, ARNP
• Leslie W Smith, DO
• Ryan L Smith, M.D.
• Samantha Smith, ARNP
• Valerie Michelle Smith, LMSW
• Melissa Snitzer, T-LMHC

• Social Worker in Mason City, IA
• Providers in Mason City, IA by specialty
• Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; 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.

Verify at the official NPI Registry.