NPIMap

Individual provider Active NPI

Kevin Charles Smith, D.O.

  • Emergency Medicine Physician
  • Fort Knox, KY
National Provider Identifier
1972592038
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
03401 Issued in KY
Practice address
289 Ireland Ave
Fort Knox, KY 40121-5111
Phone
(502) 624-9795
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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 03401 KY
Emergency Medicine Physician 207P00000X 03401 KY Primary

Addresses

Primary practice location

289 Ireland Ave
Fort Knox, KY 40121-5111

Mailing address

2250 Leestown Rd
Room 217
Lexington, KY 40511
Phone (859) 233-4511

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130110000628 KY Practitioner - Family Practice 7012160559 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians
Empact Midwest LLCGroup PAC ID 9436577517, 25 clinicians
Concord Company of Tennessee PLLCGroup PAC ID 0345588109, 68 clinicians

Practice addresses (Care Compare)

360 Amsden Ave
Versailles, KY 40383-1286
Phone (859) 873-3111

464 Linden Ave
Harrodsburg, KY 40330-1882
Phone (859) 734-5441

910 Wallace Ave
Leitchfield, KY 42754-2414
Phone (270) 259-9400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
44.67 of 100Reported as group
Quality
19.32
Promoting interoperability
0
Improvement activities
40
Cost
79.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
03401KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Aug 13, 2023 Accepting new patients
First Stop Urgent Care Broadway PSC Family Medicine CurrentSince Feb 13, 2013 Accepting new patients
Concord Company of Tennessee PLLC Emergency Medicine CurrentSince Apr 28, 2024 Accepting new patients
Empact Midwest LLC Emergency Medicine CurrentSince Sep 1, 2020 Accepting new patients
CMH ER Physicians, LLC Emergency Medicine Past Accepting new patients
Kentuckyone Health Medical Group, Inc. Family Medicine PastSince Feb 13, 2013 Accepting new patients
First Stop Urgent Care Dupont PSC Emergency Medicine Past Accepting new patients

Locations

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

217 S 3rd St
Danville, KY 40422
Phone (859) 239-1000

464 Linden Ave
Harrodsburg, KY 40330
Phone (859) 734-5441

910 Wallace Ave
Leitchfield, KY 42754
Phone (270) 259-3035

927 E Broadway
Louisville, KY 40204
Phone (502) 693-2465

110 Metker Trl
Stanford, KY 40484
Phone (606) 365-3360

360 Amsden Ave
Versailles, KY 40383
Phone (606) 873-3111

Organizations & group practices 8

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 3

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1972592038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 LEESTOWN RD",
            "address_2": "ROOM 217",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40511",
            "telephone_number": "859-233-4511",
            "fax_number": "859-281-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 IRELAND AVE",
            "city": "FORT KNOX",
            "state": "KY",
            "postal_code": "401215111",
            "telephone_number": "502-624-9795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KEVIN",
        "middle_name": "CHARLES",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "03401",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "03401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Knox, KY

Sources for this page

Verify at the official NPI Registry.