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Dr. Shannon Marie Smith , PhD

Psychologist β€’ Winter Haven, FL

Active NPI 1548747181 Individual Practitioner Female Practitioner Accepts Medicare assignment
Practice location in NPPES

1201 1st St S Ste 100a
Winter Haven, FL 338803904

Call 8632806080 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1201 1st St S Ste 100a

Winter Haven, FL 338803904

Telephone 8632806080
Fax 8632297587
Organization at the Same NPPES Address or Phone
Baycare Medical Group Inc Facility NPI 1255904413

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

CMS Doctors and Clinicians lists 1 group name: Kevin M. Kindelan, Ph.D. And Associates, P.A.. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2017

Years since graduation

9 years (graduated 2017)

CMS Doctors and Clinicians data list 2017 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2018

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Smith has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Smith as eligible to order or refer Medicare Part B clinical laboratory and imaging services and durable medical equipment (DME) for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Winter Haven and Florida

11 active clinicians are listed under Psychologist with a practice address in Winter Haven, FL (2,204 in Florida).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Winter Haven

0% of these 11 clinicians have the CMS telehealth indicator.

36.4% of these 11 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-03-25
Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

License # reported to NPPES FL PY10219

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - CLINICAL PSYCHOLOGIST

Medicare Enrollment ID

I20201210001398

Enrollment State Jurisdiction

FL

PECOS Control ID

4385056613

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Not Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Kevin M. Kindelan, Ph.d. And Associates, P.a.

2320 Commerce Point Dr, Lakeland, FL 338016880

Phone: 8638771855

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

10 listed
Dr. Robert Atkins , MD

Family Medicine

NPI 1801022892

Doctor of Medicine (M.D.)

NPI 1528633989

Doctor of Medicine (M.D.)

NPI 1053940239

Doctor of Medicine (M.D.)

Dr. Ashley Falk , MD

Family Medicine

NPI 1386671063

Doctor of Medicine (M.D.)

Dr. Nathan Falk , MD

Family Medicine

NPI 1245434299

Doctor of Medicine (M.D.)

Dr. Feisal Hamam , MD

Student in an Organized Health Care Education/Training Program

NPI 1205455474

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location December 07, 2020

Registered at 1201 1ST ST S STE 100A, WINTER HAVEN, FL 338803904 (Tel: 8632806080)

πŸ“
Updated Business Mailing Address December 07, 2020

Registered at 2995 DREW ST FL 2, CLEARWATER, FL 337593012 (Tel: 7275321355)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) December 07, 2020

Psychologist (license number reported to NPPES: FL PY10219)

βœ…
NPI Profile Active July 26, 2018

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 26, 2018

Registered at 146 2ND ST N STE 305, SAINT PETERSBURG, FL 337013361 (Tel: 7273081180)

πŸ“
Business Mailing Address (Initial Record) July 26, 2018

Registered at 146 2ND ST N STE 305, SAINT PETERSBURG, FL 337013361 (Tel: 7273081180)

πŸ‘€
Provider Name / Credentials (Initial Record) July 26, 2018

Recorded as SHANNON SMITH, PH.D.

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 26, 2018

Psychologist

🟒
Initial NPI Registration & Enumeration July 26, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1548747181
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 26, 2018
Last Update: March 25, 2021
Sole Proprietor: No

Other Psychologists in Winter Haven

Healthcare providers in Winter Haven

Mailing Address

2995 Drew St Fl 2

Clearwater, FL 337593012

Phone: 7275321355

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.