MISS KIMBERLY VICTORIA SMITH (NP-C) – Nurse Practitioner, NPI 1740893411

MISS KIMBERLY VICTORIA SMITH (NP-C) is a healthcare provider. based in Stockbridge, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials NP-C. They hold a License No. RN201498 (GA). The NPI Number for MISS KIMBERLY VICTORIA SMITH (NP-C) is 1740893411

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
MISS KIMBERLY VICTORIA SMITH (NP-C)
NPI
1740893411
Phone
(770) 996-9945
Address
1035 SOUTHCREST DR STE 250
Enumeration Date
24 August 2020
Last Update Date
24 August 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4043497770
Graduation Year
2014 (12 years ago)
PAC ID
4688112865
Group Practice PAC ID
0446502918
Professional Enrollment ID
I20240819003945
Address ID
GA303317100AT3885XSWXX506

Contacts

Secure Messaging
Peachtreevascular@direct-address.net
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness85
Years active:5State licenses:1Other namesUpdated within 12 months

9,658 NURSE PRACTITIONER in GA

Provider Addresses for MISS KIMBERLY VICTORIA SMITH (NP-C)

  • 1035 SOUTHCREST DR STE 250

    STOCKBRIDGE, GA 302816117

    Phone: (770) 996-9945

    Fax: (770) 996-7355

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 8 Open Payments records for all available years, with a total value of $158.

Total Amount is formed as General ($158) + Research ($0) + Ownership ($0) = $158.

Last reported payment date: 2024-01-22 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($75).

Total Amount

$158

General + Research + Ownership

Payments

8

Total payment records

General Amount

$158

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-22

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2024-08-19

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
I20240819003945INurse PractitionerGATBD

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 30281)

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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: 0446502918View full group profile
NameSpecialtyState
Interventional RadiologyPA
Nephrology, Internal MedicineGA
Vascular SurgeryGA
Interventional RadiologyGA
Interventional Radiology, Diagnostic RadiologyPA
Vascular SurgeryGA
Vascular SurgeryGA
Nephrology, Internal Medicine, NephrologyAR
Nephrology, Internal MedicineGA

Reviews

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Frequently asked questions

How do I look up MISS KIMBERLY VICTORIA SMITH (NP-C) by NPI?
Use NPI 1740893411 when you need to reference MISS KIMBERLY VICTORIA SMITH (NP-C) in forms, claims, or directories.
Is MISS KIMBERLY VICTORIA SMITH (NP-C)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize MISS KIMBERLY VICTORIA SMITH (NP-C)'s specialty in plain language?
Clinically, the directory lists MISS KIMBERLY VICTORIA SMITH (NP-C) with Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for MISS KIMBERLY VICTORIA SMITH (NP-C)?
The page summarizes Stockbridge, Georgia for MISS KIMBERLY VICTORIA SMITH (NP-C); expand the address list for detail.
Is MISS KIMBERLY VICTORIA SMITH (NP-C) a real provider?
This page reflects official NPPES data for NPI 1740893411. Always confirm identity and privileges with the practice and licensing boards.

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