KIM SMITH – Psychiatric/Mental Health Nurse Practitioner, NPI 1417606179

KIM SMITH is a healthcare provider. based in Madison, Alabama. specializing in NURSE PRACTITIONER. They hold a License No. 1-180295 (AL). The NPI Number for KIM SMITH is 1417606179

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
KIM SMITH
NPI
1417606179
Phone
(256) 797-3773
Address
151 FERNHILL DR NW
Enumeration Date
21 March 2022
Last Update Date
30 November 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2565718717
Graduation Year
2023 (3 years ago)
PAC ID
7113369661
Group Practice PAC ID
7911403670
Professional Enrollment ID
I20240529002623
Address ID
AL359767390GU29XXXLNXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:4State licenses:1Digital endpointsOther names

5,653 NURSE PRACTITIONER in AL

Provider Addresses for KIM SMITH

  • 151 FERNHILL DR NW

    MADISON, AL 357574500

    Phone: (256) 797-3773

    Type: Mailing

  • 29 MEDICAL CENTER LN STE A

    GUNTERSVILLE, AL 359767390

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-05-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240529002623INurse PractitionerALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35757)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7911403670View full group profile
NameSpecialtyState
Medical Oncology, Internal MedicineAL
Hematology/Oncology, Medical OncologyAL
Nurse PractitionerAL
Radiation OncologyAL
Nurse PractitionerAL

Reviews

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Frequently asked questions

What is the standard ID for KIM SMITH in the U.S.?
In the U.S., KIM SMITH is identified by NPI 1417606179.
Does the public listing show KIM SMITH as active?
KIM SMITH's NPI record reflects an active status in NPPES.
What services align with KIM SMITH's listing?
KIM SMITH's public classification highlights Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What geographic area is tied to KIM SMITH?
KIM SMITH is associated with Madison, Alabama in the same public data insurers reference.
Who maintains KIM SMITH's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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