Kenneth Alexander Smith, REGISTERED NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

578760 Issued in NY

Practice address

1634 Taylor Ave
Utica, NY 13501-5112

Phone

(315) 527-7613

Fax

(315) 732-2342

NPI assigned

Jul 28, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1285307025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 TAYLOR AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135015112",
            "telephone_number": "315-527-7613",
            "fax_number": "315-732-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 TAYLOR AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135015112",
            "telephone_number": "315-527-7613",
            "fax_number": "315-732-2342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KENNETH",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "578760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Small
• Carolyn M Smith, P.A.
• Colleen A Smith, FNPC
• Jenna Smith, MS, RD, CDN
• Karalyn Smith
• Korinne M Smith, FNP
• Krystal Smith, LMHC
• Marla H Smith, FNP
• Pamela Marie Smith, LMSW
• Jordan William Smithers, CRNA

• Registered Nurse in Utica, NY
• Providers in Utica, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.

Verify at the official NPI Registry.