Active NPI
Kenneth Ray Smith Jr, D.C.
- Chiropractor
- Clovis, CA
National Provider Identifier
1265476378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 17540
- Practice address
- 508 5TH St
Clovis, CA 93612-1105 - Phone
- (559) 299-2896
- Fax
- (559) 325-0113
- NPI assigned
- Jun 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 17540 | CA | Primary |
Addresses
Primary practice location
508 5TH St
Clovis, CA 93612-1105
Mailing address
508 5TH St
Clovis, CA 93612-1105
Phone (559) 299-2896
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101011000361 | CA | Practitioner - Chiropractic | 9234321191 | Practice locations: Clovis, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
508 5TH St
Clovis, CA 93612-1105
Phone (559) 299-2896
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17540 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1265476378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 5TH ST",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936121105",
"telephone_number": "559-299-2896",
"fax_number": "559-325-0113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "508 5TH ST",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936121105",
"telephone_number": "559-299-2896",
"fax_number": "559-325-0113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH JR",
"first_name": "KENNETH",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-16",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "17540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clovis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.