KELLY M SMART (NPI# 1720081532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720081532 |
| Entity Type | Individual |
| Full Name | KELLY M SMART |
| Credential | P.A |
| Practice Address |
141 Hillcrest Dr Clarksville TN 37043 |
| Mailing Address |
608 Norris Ave Nashville TN 37204 |
| Practice Telephone | 9315524340 |
| Practice Fax Number | 9315520999 |
| Mailing Telephone | 6156951407 |
| Mailing Fax Number | 6156951483 |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2019-10-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363A00000X | Physician Assistant | PA1125 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 620862316 | 05 | |
| KY | KENTUCKY MEDICAID | 9500536900 | 01 |
| TN | 3663312 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1100 Ted A Crozier Blvd, Suite A, Clarksville, TN 370438912 | 9318026100 | 9318026077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992246805 | Kelly Smart | Case Manager/Care Coordinator | 1502 Mary Kay Blvd, Benton, AR 72015 | 2017-03-10 |
| 1255708103 | Kelly Jean Smart | Registered Nurse | 215 Glasgow St, Clyde, NY 14433-1222 | 2015-08-26 |
| Street Address |
141 HILLCREST DR |
| City | CLARKSVILLE |
| State | TN |
| Zip Code | 37043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093321127 | John Daniel Eaton | Physical Therapist | 141 Hillcrest Dr, Clarksville, TN 37043-5088 | 2020-09-23 |
| 1861979551 | Deidra Brown | Specialist/Technologist | 141 Hillcrest Dr, Clarksville, TN 37043-5088 | 2018-07-25 |
| 1861987893 | Kyle Ryan Snell | Physical Therapist | 141 Hillcrest Dr, Clarksville, TN 37043-5088 | 2018-06-22 |
| 1710482708 | Hannah Higdon | Specialist/Technologist | 141 Hillcrest Dr, Clarksville, TN 37043-5088 | 2018-03-29 |
| 1346773413 | Ryan Edward Griesenauer | Physical Therapist | 141 Hillcrest Dr, Clarksville, TN 37043 | 2017-04-06 |
| 1639579055 | Carrie Anne Pearson | Specialist/Technologist | 141 Hillcrest Dr, Clarksville, TN 37043-5088 | 2014-09-04 |
| 1053727966 | Paul Klocek | Specialist/Technologist | 141 Hillcrest Dr, Clarksville, TN 37043-5088 | 2014-07-11 |
| 1750797593 | Casey N Moye | Physical Therapist | 141 Hillcrest Dr, Clarksville, TN 37043-5088 | 2014-07-01 |
| 1689089062 | Jason Harms | Orthopaedic Surgery | 141 Hillcrest Dr, Clarksville, TN 37043-5088 | 2014-06-24 |
| 1982032371 | Erin R Taylor | Physical Therapist | 141 Hillcrest Dr, Clarksville, TN 37043-5088 | 2013-10-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952958464 | Barbara Gallahan | Technician | 3992 Lakewood Dr., Clarksville, TN 37043 | 2019-08-20 |
| 1144874728 | Intricate Care | Registered Nurse | 2299 Raleigh Ct, Clarksville, TN 37043 | 2019-07-31 |
| 1740842145 | Caila Anne Wiblitzhouser Holm | Counselor | 755 Weatherly Drive, Clarksville, TN 37043 | 2019-07-05 |
| 1407416407 | Heartland Dental Care of Tennessee, PC | Dentist | 930 Highway 76, Clarksville, TN 37043 | 2019-06-20 |
| 1376021501 | Stephen Lawrence Rego | Case Manager/Care Coordinator | Cohen Military Family Clinic, 775 Weatherly Dr, Clarksville, TN 37043 | 2018-07-31 |
| 1366928095 | Kendra Lee | Social Worker | 775 Weatherly Dr., Clarksville, TN 37043 | 2018-07-16 |
| 1245742931 | Andrea L Edelstein | Dentist | 1818 Memorial Dr., Unit 47, Clarksville, TN 37043 | 2017-11-02 |
| 1043736119 | Megan Pritchett Landre | Behavior Technician | 990 South Ridge Trail, Clarksville, TN 37043 | 2017-08-20 |
| 1932624798 | Sandra Melissa Corral | Behavior Technician | 139e Old Trenton Rd, Suite B, Clarksville, TN 37043 | 2017-08-13 |
| 1700306032 | Sahiti Kandati | Dentist | 1777 Madison Ste Ste 100, Clarksville, TN 37043 | 2017-06-27 |
| Find all providers in zip 37043 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407472079 | Melissa Perkins | Physician Assistant | 2080 Madison St, Clarksville, TN 37043-5087 | 2020-06-19 |
| 1932735297 | Desirae Marie Sheppard | Physician Assistant | 1304 Sharptail Trl, Clarksville, TN 37042-8113 | 2020-03-19 |
| 1669011094 | Jasmine Adams | Physician Assistant | 609 Rocky Hill Rd, Clarksville, TN 37042-6019 | 2020-01-02 |
| 1700369394 | Michael English | Physician Assistant | 1871 Rains Rd, Clarksville, TN 37042-1966 | 2018-09-11 |
| 1770078040 | Novus Behavioral Health | Physician Assistant | 130 Hillcrest Dr Ste 213, Clarksville, TN 37043-5083 | 2018-06-28 |
| 1619462546 | Cody R Thomas | Physician Assistant | 1060 W Creek Coyote Trl Apt 1302, Clarksville, TN 37042-8266 | 2018-06-23 |
| 1447753314 | Vincent Michael Proctor | Physician Assistant | 775f Weatherly Dr, Clarksville, TN 37043-8942 | 2018-03-16 |
| 1124539580 | Lauren Michelle Huddleston | Physician Assistant | 1524 Madison St, Clarksville, TN 37040-3846 | 2017-10-12 |
| 1043720287 | Kathryn Fitzpatrick Rodgers | Physician Assistant | 5403 Talon Ct, Clarksville, MD 21029-1142 | 2017-10-02 |
| 1194243709 | Christina Joanne O'hara-rodriguez | Physician Assistant | 803 River Run, Clarksville, TN 37043-6042 | 2017-09-03 |
| Find all providers in CLARKSVILLE | ||||
| City | CLARKSVILLE |
| Zip Code | 37043 |
Please comment or provide details below to improve the information on KELLY M SMART.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.