Kimberly Ann Smith, NP-C - Medicare Nurse Practitioner in Fort Wayne, IN

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Kimberly Ann Smith, NP-C is a medicare enrolled "Nurse Practitioner - Family" in Fort Wayne, Indiana. She graduated from nursing school in 2011 and has 13 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Eventus Wholehealth Midwest Inc, Extended Care Specialists, Inc and her current practice location is 3512 Stellhorn Rd, Fort Wayne, Indiana. You can reach out to her office (for appointments etc.) via phone at (260) 483-9081.

Kimberly Ann Smith is licensed to practice in Indiana (license number 71004091A) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1225387400.

Contact Information

Kimberly Ann Smith, NP-C
3512 Stellhorn Rd,
Fort Wayne, IN 46815-4631
(260) 483-9081
(260) 483-9196

Map and Direction




Provider's Profile

Full NameKimberly Ann Smith
GenderFemale
SpecialityNurse Practitioner
Experience13 Years
Location3512 Stellhorn Rd, Fort Wayne, Indiana
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Kimberly Ann Smith graduated from nursing school in 2011
  NPI Data:
  • NPI Number: 1225387400
  • Provider Enumeration Date: 09/05/2012
  • Last Update Date: 09/05/2012
  Medicare PECOS Information:
  • PECOS PAC ID: 3274782156
  • Enrollment ID: I20121009000813

Medical Identifiers

Medical identifiers for Kimberly Ann Smith such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1225387400NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 71004091A (Indiana)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Eventus Wholehealth Midwest Inc418304047096
Extended Care Specialists, Inc2466407713183

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kimberly Ann Smith allows following entities to bill medicare on her behalf.
Entity NameExtended Care Specialists, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1134146079
PECOS PAC ID: 2466407713
Enrollment ID: O20050318000726
Entity NameSignify Health Medical Associates Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750845863
PECOS PAC ID: 2163764424
Enrollment ID: O20190903001552
Entity NameEventus Wholehealth Midwest Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1386252757
PECOS PAC ID: 4183040470
Enrollment ID: O20200818000277

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberly Ann Smith is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kimberly Ann Smith, NP-C
3512 Stellhorn Rd,
Fort Wayne, IN 46815-4631

Ph: (260) 483-9081		Kimberly Ann Smith, NP-C
3512 Stellhorn Rd,
Fort Wayne, IN 46815-4631

Ph: (260) 483-9081

Reviews and Comments


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Amber N Gullion, NP
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Phone: 260-469-6610    Fax: 260-969-3065

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.