Katelyn Marie Smith · Physician Assistant

1135 W University Dr, Ste 175, Rochester, MI 48307

Overview

Katelyn Marie Smith is a Physician Assistant practicing in Rochester, Michigan. The National Provider Identifier (NPI) is #1518435122, which was assigned on November 13, 2018, and the registration record was last updated on August 1, 2025. The practitioner's main practice location is at 1135 W University Dr, Ste 175, Rochester, MI 48307; the contact telephone number is 2486505864, and the fax number is 2486505865. The primary taxonomy of Katelyn Marie Smith is Physician Assistant (363A00000X). Katelyn Marie Smith is licensed to practice in the state of Michigan (#5601009664).

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Provider Information

NPI 1518435122
Entity Type Individual
Provider Name KATELYN MARIE SMITH
Gender Female
Credential PHYSICIAN ASSISTANT
Practice Address 1135 W University Dr
Ste 175
Rochester
MI 48307
Practice Telephone 2486505864
Practice Fax Number 2486505865
Mailing Address 1135 W University Dr
Ste 175
Rochester
MI 48307
Mailing Telephone 2486505864
Mailing Fax Number 2486505865
Certification Date 2025-02-11
Enumeration Date 2018-11-13
Last Update Date 2025-08-01
NPI Deactivation Date 2025-05-30
NPI Reactivation Date 2025-08-01
Is Sole Proprietor N

Doctor and Clinician Information

PAC ID 1153753108
Medicare Provider Enrollment and Chain/Ownership System (PECOS) Associate Control (PAC) ID
Full Name KATELYN M SMITH
Primary Specialty PHYSICIAN ASSISTANT
Organization Legal Name BLUE WATER URGENT CARE PLLC
Address 2700 Pointe Tremble Rd
Algonac
MI 48001-1836

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
Y363A00000XPhysician Assistant5601009664MI

Secondary Practice Locations

AddressTelephoneFax
Health Professions 1223 Central Michigan University, Mount Pleasant, MI 48859000198977423379897742433

Taxonomy Information

Primary Taxonomy

Code 363A00000X
Taxonomy Physician Assistant
Classification Physician Assistant
Grouping Physician Assistants & Advanced Practice Nursing Providers
Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers with the same taxonomy

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Caroline Rose Dolan 234 E 149th St, Bronx, NY 10451-5504Physician Assistant2025-10-10
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Chun-Rung Chen 360 Linden Oaks Ste 220, Rochester, NY 14625-2814Physician Assistant2025-10-10
Sheila Perez 9111 Park Dr, Miami Shores, FL 33138-3159Physician Assistant2025-10-10
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Location Information

Street Address 1135 W UNIVERSITY DR
STE 175
City ROCHESTER
State MI
Zip Code 48307
Country US

Providers in the same location

Provider NameAddressTaxonomyEnumeration Date
Mariam Sabah Nissan 1135 W University Dr Ste 250, Rochester, MI 48307-1886Student in an Organized Health Care Education/Training Program2025-04-09
Mazen S Afram M.D.P.C. 1135 W University Dr Ste 175, Rochester, MI 48307-1893Internal Medicine Physician2010-12-27
Zeeshan Shahriar Husain 1135 W University Dr Ste 305, Rochester, MI 48307-1892Foot & Ankle Surgery Podiatrist2005-08-10
Robert G. Dekker II 1135 W University Dr Ste 450, Rochester, MI 48307-1871Orthopaedic Foot and Ankle Surgery Physician2013-03-22
Peter Joseph Korda 1135 W University Dr, Ste 240, Rochester, MI 48307-1890Surgery Physician2006-10-19
Natalie Mariani 1135 W University Dr, Rochester, MI 48307-1871Pharmacist2017-06-23
Boondarik Sandy Phuengsomboonying 1135 W University Dr Ste 250, Rochester, MI 48307-1886Student in an Organized Health Care Education/Training Program2024-04-10
Eden Roth 1135 W University Dr Ste 425, Rochester, MI 48307-1897Physical Medicine & Rehabilitation Physician2021-05-10
Jamal Rashad Hoyte 1135 W University Dr, Rochester, MI 48307-1871Student in an Organized Health Care Education/Training Program2025-06-24
Specialists In Rehabilitation Medicine PC 1135 W University Dr Ste 175, Rochester, MI 48307-1893Physical Medicine & Rehabilitation Physician2006-02-21
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Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Align Chiropractic Clinic 427 6th St, Rochester, MI 48307-1401Chiropractor2015-06-15
Star Chiropractic LLC 407 6th St Ste B, Rochester, MI 48307-1456Medical Specialty Clinic/Center2009-01-12
Michael Aria Assadi 1101 W University Dr, Rochester, MI 48307Student in an Organized Health Care Education/Training Program2025-05-15
Sarah Alzaroui 1101 W University Drive 2 South, Rochester Hills, MI 48307Student in an Organized Health Care Education/Training Program2025-04-03
Amy Wright 811 Oakwood Dr Ste 203, Rochester, MI 48307-1362Obstetrics & Gynecology Physician2005-09-06
Prime Home Help LLC 54164 Deer Ridge Court, Rochester, MI 48307In Home Supportive Care Agency2025-04-07
Daniel Gizynski 530 Pine St, Suite #2 & 3, Rochester, MI 48307-1482Chiropractor2006-07-28
Dina Khoury 600 N Main St, Ste 100, Rochester, MI 48307-1426Dentist2007-01-19
Travis Rich 969 Oakwood Dr, Rochester Hills, MI 48307-1318Podiatrist2021-06-21
Manal Elia 130 Hampton Circle, Suite 150, Rochester Hills, MI 48307Massage Therapist2014-07-23
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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.