Individual provider Active NPI

Kerri Lynn Smith, RD

  • Registered Dietitian
  • Owosso, MI
National Provider Identifier
1215109152
Registry record updated May 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
717192 Issued in MI
Practice address
826 W King St
Suite R
Owosso, MI 48867-2120
Phone
(989) 729-4509
NPI assigned
Apr 1, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 717192 MI Primary

Addresses

Primary practice location

826 W King St
Suite R
Owosso, MI 48867-2120

Mailing address

8550 Parks Rd
Ovid, MI 48866-8626
Phone (517) 256-1607

Other identifiers 1

IdentifierTypeStateIssuer
ON54100OtherMIMEDICARE PART B MNT

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
717192MIMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304985600000",
    "number": "1215109152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 PARKS RD",
            "city": "OVID",
            "state": "MI",
            "postal_code": "488668626",
            "telephone_number": "517-256-1607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 W KING ST",
            "address_2": "SUITE R",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488672120",
            "telephone_number": "989-729-4509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KERRI",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2011-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "717192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B MNT",
            "identifier": "ON54100",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owosso, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2011; 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.