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SMITH COUNTY FAMILY MEDICAL LLC
NPI 1053867184
Nurse Practitioner - Family in Gordonsville, TN

Active since August 29, 2016CLIA 44D2023170 · Waiver
8 NEW MIDDLETON HWY, STE A, GORDONSVILLE, TN 38563(615) 735-8008(615) 735-0008 Get Directions Write a Review

NPPES record last updated: July 12, 2018. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 12, 2018, Aug 29, 2016 (2 updates tracked since 2016).

About Smith County Family Medical Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SMITH COUNTY FAMILY MEDICAL LLC (NPI 1053867184) is a healthcare organization registered as a family in Gordonsville, Tennessee and active in the NPI registry since August 2016. The organization holds a CLIA Waiver certificate valid through April 17, 2027 and lists Kimberly Dawn Gregory, Owner/nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1053867184
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameSMITH COUNTY FAMILY MEDICAL LLC
Location Address8 NEW MIDDLETON HWY, STE AGordonsville, TN 38563
Mailing Address8 New Middleton Hwy, Ste AGordonsville, TN 38563 · (615) 735-8008 · Fax (615) 735-0008
Phone(615) 735-8008
Fax(615) 735-0008
Organization SubpartNo
Authorized OfficialKimberly Dawn GregoryOwner/nurse Practitioner · (615) 735-8008
Enumeration DateAugust 29, 2016
Last NPPES UpdateJuly 12, 20182 updates tracked since enumeration
✔ NPI 1053867184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TN · 13604
8 NEW MIDDLETON HWY, Gordonsville, TN 38563
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Smith County Family Medical Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Smith County Family Medical LLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Anna Sircy, FNP
Nurse Practitioner
NPI 1518611425
8 NEW MIDDLETON HWY
Gordonsville, TN 38563
(615) 735-8008
✔ PECOS✔ Accepts Medicare0.6 mi
Kimberly Gregory, MSN, FNP-BC
Nurse Practitioner
NPI 1912156696
8 NEW MIDDLETON HWY STE A
Gordonsville, TN 38563
(615) 735-8008
✔ PECOS✔ Accepts Medicare1.3 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D2023170

Smith County Family Medical · Gordonsville, TN
Active · expires Apr 17, 2027
CLIA Number44D2023170
Laboratory TypePhysician Office
Certificate Effective DateApril 18, 2025
Certificate Expiration DateApril 17, 2027
Laboratory DirectorRachel Boles
Laboratory Phone(615) 735-8008
Laboratory LocationSmith County Family Medical8 New Middleton Hwy Suite A, Gordonsville, TN 38563
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Smith County Family Medical LLC's NPI number?

The NPI number for Smith County Family Medical LLC is 1053867184. It was assigned to this organization in the NPPES registry on August 29, 2016.

Where is Smith County Family Medical LLC located?

Smith County Family Medical LLC is located at 8 New Middleton Hwy Ste A, Gordonsville, TN 38563. The listed phone number is (615) 735-8008.

What is Smith County Family Medical LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Smith County Family Medical LLC enrolled in Medicare?

Yes. Smith County Family Medical LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Smith County Family Medical LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Smith County Family Medical LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Smith County Family Medical LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2023170) is associated with this NPI, valid through April 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Smith County Family Medical LLC was last updated on July 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.