Kelley Jenean Smith

Primary specialty

CounselorTaxonomy code 101Y00000X

License

PRC14827 Issued in DC

Practice address

Minnesota Avenue
3946 Minnesota Avenue NE
Washington, DC 20019-6044

Phone

(202) 398-8683

Fax

(202) 548-8600

NPI assigned

Nov 26, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelley.smith@uhci.eclinicaldirectplus.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.

• Unity Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Washington, DC
  • NPI 1093894172
  Medicare reassignment NPD
• Unity Health Care Inc.

  dba Unity Health Pharmacy

  • Community/Retail Pharmacy
  • Washington, DC
  • NPI 1346014412
  NPD

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1912477647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MINNESOTA AVENUE",
            "address_2": "3946 MINNESOTA AVENUE NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200196044",
            "telephone_number": "202-398-8683",
            "fax_number": "202-548-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MINNESOTA AVENUE",
            "address_2": "3946 MINNESOTA AVENUE NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200196044",
            "telephone_number": "202-398-8683",
            "fax_number": "202-548-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11350 Random Hills Rd Ste 240",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220306044",
            "country_code": "US",
            "telephone_number": "703-537-0700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELLEY",
        "middle_name": "JENEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-26",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701007939",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "DC",
            "license": "PRC14827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathia Tawana Shinad Smith, MD MS
• Kathleen Judge Smith, LICSW
• Kaylah Smith
• Keann Smith
• Kelby Smith
• Kellie Smith
• Kelly Smith
• Kelly Nicole Smith, LICSW, LCSW
• Keniah Nigel Smith
• Kenneth Edward Smith

• Counselor in Washington, DC
• Providers in Washington, DC by specialty
• Counselor in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.