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KIMBERLY K SMITH M ED
NPI 1972789600
Counselor - Mental Health in Fort Wayne, IN

Active since January 11, 2008PECOS Enrolled
909 E STATE BLVD, FORT WAYNE, IN 46805(260) 481-2700(260) 481-2717 Get Directions Write a Review

NPPES record last updated: March 15, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kimberly K Smith M Ed NPPES

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

KIMBERLY K SMITH M ED (NPI 1972789600) is an individual mental health provider in Fort Wayne, Indiana, licensed in Indiana (39002899A) and active in the NPI registry since January 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1972789600
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKIMBERLY K SMITHCredential: M ED
Location Address909 E STATE BLVDFort Wayne, IN 46805-3404
Mailing Address11109 Parkview Plaza Dr # 117Fort Wayne, IN 46845-1701 · (260) 266-6013
Phone(260) 481-2700
Fax(260) 481-2717
Sole ProprietorNo
Enumeration DateJanuary 11, 2008
Last NPPES UpdateMarch 15, 2021
NPPES CertifiedMarch 15, 2021
✔ NPI 1972789600 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in IN · 39002899A
909 E STATE BLVD, Fort Wayne, IN 46805
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kimberly K Smith M Ed is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Kimberly Smith reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Park Center Inc
Same address
Mental Health (Including Community Mental Health Center)
909 E STATE BLVD
Fort Wayne, IN 46805
  • Reassigned Medicare billing, Indiana enrollment
  • 103 clinicians in this Medicare group
NPI 1306897004 (260) 481-2700

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

Other Providers at the Same Location NPPES 20

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

COURTNEY LESLEY WASHINGTON
Counselor
909 E STATE BLVD
FORT WAYNE, IN 46805
Allen County (260) 481-2700
JENNIFER PERRY MS
Counselor (Mental Health)
909 E STATE BLVD
FORT WAYNE, IN 46805
Allen County (260) 481-2700
MICHELLE ELISE WIESE MD
Psychiatry & Neurology (Psychiatry)
909 E STATE BLVD
FORT WAYNE, IN 46805
Allen County (260) 481-2700
SARAH MICHELLE MOORE APRN-CNM, PMHNP-BC
Nurse Practitioner
909 E STATE BLVD
FORT WAYNE, IN 46805
Allen County (260) 481-2700
JULIE NAY WINN BS
Case Manager/Care Coordinator
909 E STATE BLVD
FORT WAYNE, IN 46805
Allen County (260) 481-2700
TONYA J EIDEN LMHC, MS
Counselor (Mental Health)
909 E STATE BLVD
FORT WAYNE, IN 46805
Allen County (260) 481-2700
ANGELA C DESPENZA LPN
Licensed Practical Nurse
909 E STATE BLVD
FORT WAYNE, IN 46805
Allen County (260) 481-2700
MEGAN I FIGUEROA RN
Registered Nurse
909 E STATE BLVD
FORT WAYNE, IN 46805
Allen County (260) 481-2700

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 Kimberly Smith's NPI number?

The NPI number for Kimberly Smith is 1972789600. It was assigned to this individual provider in the NPPES registry on January 11, 2008.

Where is Kimberly Smith located?

Kimberly Smith practices at 909 E State Blvd, Fort Wayne, IN 46805. The listed phone number is (260) 481-2700.

What is Kimberly Smith's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Kimberly Smith enrolled in Medicare?

Yes. Kimberly Smith is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kimberly Smith's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Smith reassigns Medicare benefits to Park Center Inc (Fort Wayne, IN). 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 Kimberly Smith's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kimberly Smith accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource and Cigna Healthcare list Kimberly 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 Kimberly Smith was last updated on March 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.