Kelly H Smith, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APN16079 Issued in TN

Practice address

975 E. Third Street
Chattanooga, TN 37403-2147

Phone

(423) 778-7608

Fax

(423) 778-2360

NPI assigned

Aug 18, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• Kelly R Hancock Former name

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

University of Tennessee, HSC, College of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marshall Medical Center SouthGroup PAC ID 0648534495, 43 clinicians

Highlands Anesthesia ServicesGroup PAC ID 3678941424, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marshall Medical Centers Hospital, Boaz, AL, CCN 010005
• Highlands Medical Center Hospital, Scottsboro, AL, CCN 010061

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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.

• Highlands Anesthesia Services

  • Anesthesiology Physician
  • Scottsboro, AL
  • NPI 1255050753

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Marshall Medical Center South

  • Certified Registered Nurse Anesthetist
  • Boaz, AL
  • NPI 1497269799

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HH Health System - Jackson LLC

  • General Acute Care Hospital
  • Scottsboro, AL
  • NPI 1699444976
  Care Compare affiliation
• HH Health System - Marshall LLC

  • General Acute Care Hospital
  • Boaz, AL
  • NPI 1407313760
  Care Compare affiliation

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

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458518400000",
    "number": "1902186273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11225",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374012225",
            "telephone_number": "423-892-5602",
            "fax_number": "423-892-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 E. THIRD STREET",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032147",
            "telephone_number": "423-778-7608",
            "fax_number": "423-778-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELLY",
        "middle_name": "H",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-18",
        "last_updated": "2016-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN169779",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN16079",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-105660",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-105660",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "4308816",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003116099A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133602",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "HANCOCK",
            "middle_name": "R",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joyce Victoria Smith, LPN
• Julia Denise Smith, REGISTERED NURSE
• Kaitlyn Brooke Smith, NP
• Karen S Smith, OTR
• Katy Smith, APRN
• Kevin Smith, MD
• Kimberly Kay Smith, MD
• Kristen Lamm Smith, AGACNP-BC
• Kristiana Smith, LPN
• Kristin Smith, MS

• Certified Registered Nurse Anesthetist in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; 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.