Individual provider Active NPI

Kendra K. Smith, M.D.

  • Family Medicine Physician
  • Olympia, WA
National Provider Identifier
1033276704
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00028058 Issued in WA
Practice address
700 Lilly Rd NE
Olympia, WA 98506-5115
Phone
(360) 923-7000
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00028058 WA Primary

Addresses

Primary practice location

700 Lilly Rd NE
Olympia, WA 98506-5115

Mailing address

700 Lilly Rd NE
Olympia, WA 98506-5115
Phone (360) 923-7000

Other identifiers 1

IdentifierTypeStateIssuer
8136350MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20080130000076 WA Practitioner - Family Practice 6204918295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

700 Lilly Rd NE
Olympia, WA 98506-5115
Phone (360) 923-7000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Kaiser Foundation Health Plan of Washington Family Medicine CurrentSince Jan 1, 2008 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jan 1, 2008 Accepting new patients

Locations

700 Lilly Rd NE
Olympia, WA 98506
Phone (360) 923-7000

3030 Limited Ln NW
Olympia, WA 98502
Phone (360) 352-6000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: ksmith49459@ghc.direct-ci.net

Organizations & group practices 3

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1033276704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065115",
            "telephone_number": "360-923-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065115",
            "telephone_number": "360-923-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KENDRA",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00028058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8136350",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "700 Lilly Rd NE",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.