KELLY E SMITH (FNP-C) – Family Nurse Practitioner, NPI 1629849039

KELLY E SMITH (FNP-C) is a healthcare provider. based in Fort worth, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 1149617 (TX). The NPI Number for KELLY E SMITH (FNP-C) is 1629849039

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
KELLY E SMITH (FNP-C)
NPI
1629849039
Phone
Not provided
Address
2550 RIVER PARK PLZ
Enumeration Date
15 January 2024
Last Update Date
15 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8177311289
Graduation Year
2023 (3 years ago)
PAC ID
8426491069
Group Practice PAC ID
6800850470
Professional Enrollment ID
I20240209003433
Address ID
TX761160921FO2550XPLZX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for KELLY E SMITH (FNP-C)

  • 2550 RIVER PARK PLZ

    FORT WORTH, TX 761160920

    Phone:

    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 1 Open Payments records for all available years, with a total value of $15.

Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.

Last reported payment date: 2024-08-26 • Largest payer in this snapshot: Lilly USA, LLC ($15).

Total Amount

$15

General + Research + Ownership

Payments

1

Total payment records

General Amount

$15

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-26

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Lilly USA, LLC$15
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: 2024-02-09

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
I20240209003433INurse PractitionerTXTBD

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 76116)

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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: 6800850470View full group profile
NameSpecialtyState
Physician AssistantTX
Internal MedicineTX
-TX
Physician AssistantTX
Family PracticeTX
Nurse PractitionerTX
Nurse PractitionerTX
Physician AssistantTX
Nurse PractitionerTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

Is there an official ID for KELLY E SMITH (FNP-C) in U.S. healthcare records?
The official identifier for KELLY E SMITH (FNP-C) is NPI 1629849039.
Is there an active status for KELLY E SMITH (FNP-C)?
For scheduling context, KELLY E SMITH (FNP-C) is shown as active in the registry.
What clinical focus is listed for KELLY E SMITH (FNP-C)?
At a glance, KELLY E SMITH (FNP-C) is tied to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for KELLY E SMITH (FNP-C)?
Travel planning: use Fort Worth, Texas as the reference point for KELLY E SMITH (FNP-C), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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