Carolyn Smith, RN – Case Manager/Care Coordinator

Key facts

NPI: 1154538460
Entity type: Individual (NPI type 1)
Primary specialty: Case Manager/Care Coordinator 171M00000X
License: CM 9533 (AK)
Practice address: 1500 Kanakanak Road
Dillingham, AK 99576-0310
Phone: (907) 842-4139
Fax: (907) 842-4106
NPI assigned: May 17, 2007
Sex: Female
Sole proprietor: Yes

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.

Bristol Bay Native Association Case Management Agency · Dillingham, AK · NPI 1346422136

NPD (past)

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Registered Nurse

State licenses

License	State	Type	Specialty
CM 9533	AK	MD	Case Manager/Care Coordinator

Practice roles

Organization	Specialty	Status	New patients
Bristol Bay Native Association		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Case Manager/Care Coordinator	171M00000X	CM 9533	AK	Yes

Addresses

Primary practice location

1500 Kanakanak Road
Dillingham, AK 99576-0310

Mailing address

PO Box 310
Dillingham, AK 99576-0310
Phone (907) 842-4139

Other identifiers

Identifier	Type	State	Issuer
CM 9533	Medicaid	AK

Other providers in Dillingham, AK

All providers in Dillingham, AK · Case Manager/Care Coordinator in Alaska

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.