Kathleen Smotherman

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW12211 Issued in FL

Practice address

1955 US 1 S
C-2
St Augustine, FL 32086-3708

Phone

(904) 209-6215

NPI assigned

Sep 6, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kathy A Smotherman Other name

Medicare fee-for-service enrollment

Enrolled in FL

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

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.

• Sma Healthcare Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Daytona Beach, FL
  • NPI 1356329163
  Medicare reassignment NPD
• Sma Healthcare, Inc

  • Federally Qualified Health Center (FQHC)
  • Daytona Beach, FL
  • NPI 1255950168
  NPD
• Sma Healthcare Inc

  • Psychiatric Hospital
  • Daytona Beach, FL
  • NPI 1750369666
  NPD (past)

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

{
    "created_epoch": "1409961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409961600000",
    "number": "1992106298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 US 1 S",
            "address_2": "C-2",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863708",
            "telephone_number": "904-209-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 US 1 S",
            "address_2": "C-2",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863708",
            "telephone_number": "904-209-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOTHERMAN",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-06",
        "last_updated": "2014-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "SMOTHERMAN",
            "middle_name": "A",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shakayla Shanice Smith, RN
• Shantel Anitra Smith, PHARMD
• Stephanie Smith, PHARMD
• Taylor Smith
• Ty Smith, RBT
• Katherine Snider, PHARMD
• Natalia Snigurskaya
• Summer A Snoek, PT
• Jessica Snuggs
• Richard L Snyder, MD

• Clinical Social Worker in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2014; 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.