KELLIE DANIELLE SMITH FNP
NPI 1124779129
Nurse Practitioner - Family in Oklahoma City, OK
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
Specialties & Licenses 2
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignment
Medicare enrollment records show Kellie Smith reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Shawnee, OK 74804
- Reassigned Medicare billing, Oklahoma enrollment
- 42 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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.
Which organization bills Medicare for Kellie Smith's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kellie Smith reassigns Medicare benefits to Advance Physicians Group (Shawnee, OK). The 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 Kellie Smith's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kellie Smith accept?
Health plans from Blue Cross and Blue Shield of Oklahoma, Mending Health and UnitedHealthcare 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 2 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.
# Kellie Danielle Smith, FNP · NPI 1124779129
Family physician in Oklahoma City, Oklahoma. Individual provider, active in the CMS NPPES registry since January 12, 2022.
## Identity
- **NPI:** 1124779129 (Entity type: Individual)
- **Enumerated:** January 12, 2022
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 216046 (Oklahoma)
- **Sole proprietor:** No
## Practice location
- **Address:** 4510 NW 39TH ST, Oklahoma City, OK 73122-2503
- **Phone:** (405) 759-4300
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Advance Physicians Group (NPI 1750395448, Shawnee, OK), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** September 3, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1124779129) · Data from the CMS NPPES public registry.