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MRS. KELLY SMIDEBUSH ARNP
NPI 1104176833
Nurse Practitioner in Crestview, FL

Active since September 10, 2012PECOS EnrolledAccepts Medicare Assignment
84.04/100
CMS Quality Rating
129 E REDSTONE AVE, SUITE A, CRESTVIEW, FL 32539(850) 682-7212(850) 682-6302 Get Directions Write a Review

NPPES record last updated: October 5, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mrs. Kelly Smidebush Arnp NPPES

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

MRS. KELLY SMIDEBUSH ARNP (NPI 1104176833) is an individual nurse practitioner in Crestview, Florida, licensed in Florida (ARNP9279024) and active in the NPI registry since September 2012. She is enrolled in Medicare PECOS, is affiliated with North Okaloosa Medical Center, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1104176833
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMRS. KELLY SMIDEBUSHCredential: ARNP
Location Address129 E REDSTONE AVE, SUITE ACrestview, FL 32539-5350
Mailing Address129 E Redstone Ave, Suite ACrestview, FL 32539-5350 · (850) 682-7212 · Fax (850) 682-6302
Phone(850) 682-7212
Fax(850) 682-6302
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateSeptember 10, 2012
Last NPPES UpdateOctober 5, 2012
✔ NPI 1104176833 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in FL · ARNP9279024
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
129 E REDSTONE AVE, Crestview, FL 32539
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Kelly Smidebush Arnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527218056
PECOS Enrollment IDI20121018000582
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
240 services214 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
137 services131 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
24 services21 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

North Okaloosa Medical Center

Acute Care Hospitals · Crestview, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100122
Location151 Redstone Ave SECrestview, FL 32539 · Okaloosa County
Emergency services Birthing friendly

Hca Florida Fort Walton-Destin Hospital

Acute Care Hospitals · Fort Walton Beach, FL
3/5 CMS rating
OwnershipProprietary
CMS Certification Number100223
Location1000 Mar-Walt DrFort Walton Beach, FL 32547 · Okaloosa County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32539 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.04/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality86.77
Improvement Activities40
Cost58.58

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OKALOOSA CARDIOLOGY P A
Internal Medicine (Cardiovascular Disease)
129 E REDSTONE AVE, SUITE A
CRESTVIEW, FL 32539
Okaloosa County (850) 682-7212
JUAN CARLOS ZARATE MD
Internal Medicine (Cardiovascular Disease)
129 E REDSTONE AVE, SUITE A
CRESTVIEW, FL 32539
Okaloosa County (850) 682-7212

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 Kelly Smidebush's NPI number?

The NPI number for Kelly Smidebush is 1104176833. It was assigned to this individual provider in the NPPES registry on September 10, 2012.

Where is Kelly Smidebush located?

Kelly Smidebush practices at 129 E Redstone Ave Suite A, Crestview, FL 32539. The listed phone number is (850) 682-7212.

What is Kelly Smidebush's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Kelly Smidebush enrolled in Medicare?

Yes. Kelly Smidebush is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Kelly Smidebush affiliated with any hospitals?

According to CMS data, Kelly Smidebush is affiliated with North Okaloosa Medical Center and Hca Florida Fort Walton-Destin Hospital.

When was this NPI record last updated?

The NPPES record for Kelly Smidebush was last updated on October 5, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.