Kenneth Wayne Smith, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

MD020006 Issued in TN

Practice address

2 Sheridan SQ
Suite 200
Kingsport, TN 37660-7399

Phone

(423) 246-8061

Fax

(423) 243-8278

NPI assigned

Aug 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwsmd@brncpc.gwaydirect.com

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.

• Blue Ridge Neuroscience Center, P.C.

  • Specialist
  • Kingsport, TN
  • NPI 1871502880
  Medicare reassignment NPD

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1033101126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SHERIDAN SQ STE 200",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607399",
            "telephone_number": "423-246-8061",
            "fax_number": "423-243-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SHERIDAN SQ",
            "address_2": "SUITE 200",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607399",
            "telephone_number": "423-246-8061",
            "fax_number": "423-243-8278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KENNETH",
        "middle_name": "WAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TN",
            "license": "MD020006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3047670",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Nicole Smith, P.T.
• Jamie Edwards Smith, PT
• John Alan Smith, D.D.S.,P.C.
• Jonathan Lee Smith, DPT
• Joshua Dale Smith, FNP
• Kevin Michael Smith, PHARMD
• Melissa Dawn Smith, FNP
• Michelle Smith, FNP
• Nancy Smith, NP-C
• Phinetta Kay Smith, BS

• Neurological Surgery Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Neurological Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.