Individual provider Active NPI

Rachel S Smith, MD

  • Pediatric Adolescent Medicine Physician
  • Lawrence, KS
National Provider Identifier
1013970979
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
0423021 Issued in KS
Practice address
2415 Massachusetts St
Lawrence, KS 66046-4827
Phone
(785) 843-3750
Fax
(785) 832-4887
NPI assigned
Apr 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 0423021 KS Primary

Addresses

Primary practice location

2415 Massachusetts St
Lawrence, KS 66046-4827

Mailing address

2415 Massachusetts St
Lawrence, KS 66046-4827
Phone (785) 843-3750

Other identifiers 2

IdentifierTypeStateIssuer
100116690CMedicaidKS
102792OtherKSBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0423021KSMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Partners in Pediatrics PA Adolescent Medicine Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1013970979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 MASSACHUSETTS ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660464827",
            "telephone_number": "785-843-3750",
            "fax_number": "785-832-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 MASSACHUSETTS ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660464827",
            "telephone_number": "785-843-3750",
            "fax_number": "785-832-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RACHEL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "KS",
            "license": "0423021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100116690C",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "102792",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.