Active NPI
Kenneth Lee Smylie, PHD
- Pastoral Counselor
- Gainesville, FL
National Provider Identifier
1275124109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- MT1828
- Practice address
- 8711 NW 40TH Cir
Gainesville, FL 32653-0078 - Phone
- (352) 215-8844
- NPI assigned
- Feb 2, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | MT1828 | FL | Primary |
Addresses
Primary practice location
8711 NW 40TH Cir
Gainesville, FL 32653-0078
Mailing address
8711 NW 40TH Cir
Gainesville, FL 32653-0078
Phone (352) 215-8844
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT1828 | FL | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612224000000",
"number": "1275124109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8711 NW 40TH CIR",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326530078",
"telephone_number": "352-215-8844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8711 NW 40TH CIR",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326530078",
"telephone_number": "352-215-8844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMYLIE",
"first_name": "KENNETH",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-02-02",
"last_updated": "2021-02-02",
"certification_date": "2021-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Pastoral",
"state": "FL",
"license": "MT1828",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.