Kyle Patrick Smith, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

35650 Issued in SC

Practice address

559 Vincent St.
Space Base Delta 1
Peterson Space Force Base, CO 80914

Phone

(719) 556-1109

NPI assigned

Jun 4, 2014

Last updated

Jul 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 21St Medgrp-Peterson

  dba DoD SCHRIEVER ePhcy

  • Military/U.S. Coast Guard Pharmacy
  • Schriever AFB, CO
  • NPI 1487069621
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1003229394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 VINCENT ST.",
            "address_2": "SPACE BASE DELTA 1",
            "city": "PETERSON SPACE FORCE BASE",
            "state": "CO",
            "postal_code": "80914",
            "telephone_number": "719-556-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 VINCENT ST.",
            "address_2": "SPACE BASE DELTA 1",
            "city": "PETERSON SPACE FORCE BASE",
            "state": "CO",
            "postal_code": "80914",
            "telephone_number": "719-556-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KYLE",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-04",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "SC",
            "license": "35650",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "35650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Laurelin Fil, NP
• Heather Smith Harvey, PT PHYSICAL THERAPIS
• Kathryn E O'Connell, LCSW
• Yesenia Marie Rivera, NP
• Heather Rybar, D.D.S.
• Jena Sullenberger, RN
• Kyle Warf, DPT
• Jeffrey Wentz, MD
• Brittany Wheat
• Trae Williams

• Pharmacist in Peterson Space Force Base, CO
• Providers in Peterson Space Force Base, CO by specialty
• Pharmacist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.