Individual provider Active NPI

Kendra Brielle Smertneck

  • Personal Care Attendant
  • Moundsville, WV
National Provider Identifier
1063160646
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Practice address
34 Litman Dr
Moundsville, WV 26041-5145
Phone
(304) 650-4736
NPI assigned
Mar 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X Primary

Addresses

Primary practice location

34 Litman Dr
Moundsville, WV 26041-5145

Mailing address

34 Litman Dr
Moundsville, WV 26041-5145
Phone (304) 650-4736

Other identifiers 3

IdentifierTypeStateIssuer
1821206228MedicaidWV
1356607394MedicaidWV
125553494MedicaidWV

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

NPI Registry JSON

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1063160646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 LITMAN DR",
            "city": "MOUNDSVILLE",
            "state": "WV",
            "postal_code": "260415145",
            "telephone_number": "304-650-4736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 LITMAN DR",
            "city": "MOUNDSVILLE",
            "state": "WV",
            "postal_code": "260415145",
            "telephone_number": "304-650-4736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMERTNECK",
        "first_name": "KENDRA",
        "middle_name": "BRIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821206228",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356607394",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125553494",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moundsville, WV

Sources for this page

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