Katelin Elizabeth Smith, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

2021028231 Issued in MO

Practice address

2150 Main St
Boonville, MO 65233-1941

Phone

(660) 882-6552

NPI assigned

Feb 12, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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 and National Provider Directory roles.

• Wal-Mart Stores East LP

  • Community/Retail Pharmacy
  • Boonville, MO
  • NPI 1043237365
  NPD (past)
• Wal-Mart Stores East, LP

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1644624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644624000000",
    "number": "1013662675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 MAIN ST",
            "city": "BOONVILLE",
            "state": "MO",
            "postal_code": "652331941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 MAIN ST",
            "city": "BOONVILLE",
            "state": "MO",
            "postal_code": "652331941",
            "telephone_number": "660-882-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATELIN",
        "middle_name": "ELIZABETH",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-12",
        "last_updated": "2022-02-12",
        "certification_date": "2022-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2021028231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monique F Schrader, MALPC
• Scottkoerner, D.D.S.,P.C.
• Bobby Self
• Sabrina Dawn Simmons, PHARM. D.
• Sisters Supportive Services, Inc.
• Robyn Smith, PHARM.D.
• Sarah Elizabeth Sommer, D.C.
• Marissa Leigh Ann Stanic, RN, BSN, CCRN, APRN
• Cla H. Stearns II, PHD
• Kim Jean Stephens, MHS, CCC-SLP

• All providers in Boonville, MO
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2022; 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.