KELLIE DANIELLE SMITH FNP
NPI 1124779129
Nurse Practitioner - Family in Oklahoma City, OK

Active since January 12, 2022PECOS EnrolledAccepts Medicare Assignment
4510 NW 39TH ST, OKLAHOMA CITY, OK 73122(405) 759-4300 Get Directions Write a Review

NPPES record last updated: September 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 3, 2024, Jan 12, 2022 (2 updates tracked since 2022).

About Kellie Danielle Smith Fnp NPPES

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

KELLIE DANIELLE SMITH FNP (NPI 1124779129) is an individual family provider in Oklahoma City, Oklahoma, licensed in Oklahoma (216046) and active in the NPI registry since January 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1124779129
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKELLIE DANIELLE SMITHCredential: FNP
Location Address4510 NW 39TH STOklahoma City, OK 73122-2503
Mailing Address4510 Nw 39th StOklahoma City, OK 73122-2503 · (843) 929-2590
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateJanuary 12, 2022
Last NPPES UpdateSeptember 3, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 3, 2024
NPI 1124779129 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in OK · 216046
Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License 25717 (SC)
4510 NW 39TH ST, Oklahoma City, OK 73122

Other Names 1

Former Name (1)Kellie Danielle Dickey

Accepted Insurance

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

Kellie Danielle Smith Fnp 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 ID6901337278
PECOS Enrollment IDI20240927002105
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 73122 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
$82.46 typical visit price
range $53.00 – $162.61
Typical copayment $20.61 (range $13.25 – $40.65)
Most-billed visit code 99203
Established Patient
$94.27 typical visit price
range $16.68 – $132.40
Typical copayment $23.56 (range $4.17 – $33.10)
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.

Other Providers at the Same Location NPPES 4

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

Radiology (Diagnostic Radiology)
4510 NW 39TH ST
OKLAHOMA CITY, OK 73122
General Practice
4510 NW 39TH ST
OKLAHOMA CITY, OK 73122
Family Medicine
4510 NW 39TH ST
OKLAHOMA CITY, OK 73122
Nurse Practitioner
4510 NW 39TH ST
OKLAHOMA CITY, OK 73122

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 Kellie Smith's NPI number?

The NPI number for Kellie Smith is 1124779129. It was assigned to this individual provider in the NPPES registry on January 12, 2022. The provider is also known as Kellie Danielle Dickey.

Where is Kellie Smith located?

Kellie Smith practices at 4510 NW 39th St, Oklahoma City, OK 73122. The listed phone number is (405) 759-4300.

What is Kellie Smith's specialty?

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

Is Kellie Smith enrolled in Medicare?

Yes. Kellie Smith 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.

What insurance does Kellie Smith accept?

Health plans from Blue Cross and Blue Shield of Oklahoma, Medica and Mending Health list Kellie Smith as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kellie Smith was last updated on September 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.