NPIMap

Individual provider Active NPI

Mary Kelli Smith, M.D.

  • Family Medicine Physician
  • Covington, LA
National Provider Identifier
1962451518
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
307654 Issued in LA
Practice address
1000 Ochsner Blvd
Covington, LA 70433-8107
Phone
(985) 898-7150
Fax
(985) 898-7151
NPI assigned
May 10, 2006
Last updated
May 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 12887 MS
Family Medicine Physician 207Q00000X 307654 LA Primary

Addresses

Primary practice location

1000 Ochsner Blvd
Covington, LA 70433-8107

Mailing address

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-4000

Other identifiers 1

IdentifierTypeStateIssuer
00123462MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, LA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100223000072 MS Practitioner - Family Practice 9537203054 Reassigns benefits to 2 organizations
Practice locations: Magee, MS
I20180223001801 LA Practitioner - Family Practice 9537203054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

1000 Ochsner Blvd
Covington, LA 70433-8107
Phone (985) 875-2828

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Feb 1, 2018 Accepting new patients
Keystone Medical Services of Ms, Inc CurrentSince Apr 15, 2012 Accepting new patients
Magee Benevolent Association Current Accepting new patients
Magee Benevolent Association Current Accepting new patients
South Central Regional Medical Center CurrentSince Jan 1, 2011 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
South Central Regional Medical Center CurrentSince Jan 1, 2011 Accepting new patients
Karen M Bruce MD PLLC Family Medicine Current Accepting new patients
Ochsner Clinic LLC CurrentSince Feb 1, 2018 Accepting new patients
University Family Medicine Associates, PLLC Past Accepting new patients
Hometown Healthcare of Magee, PLLC Family Medicine Past Accepting new patients

Locations

1000 Ochsner Blvd
Covington, LA 70433
Phone (985) 898-7051

1514 Jefferson Hwy
New Orleans, LA 70121

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

104 Acadia Park Dr
#9390
Raceland, LA 70394
Phone (225) 336-3100

1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303

300 SE 3rd Ave
Magee, MS 39111
Phone (601) 849-5070

376B Simpson Highway 149
Magee, MS 39111
Phone (601) 849-1236

Interoperability endpoints

  • Direct secure messaging: marysmith@mscm.allscriptsdirect.net
  • Direct secure messaging: msmith507131@direct.ochsner.org

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1962451518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 OCHSNER BLVD",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704338107",
            "telephone_number": "985-898-7150",
            "fax_number": "985-898-7151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARY",
        "middle_name": "KELLI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "12887",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "307654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00123462",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.