Kristen Leigh Smith, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

33206 Issued in NE

Practice address

4076 Neely Road
BLDG. 4076
Ft Wainwright, AK 99703-7440

Phone

(907) 361-4000

Fax

(907) 361-4809

NPI assigned

Feb 7, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1549497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1306301940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4076 NEELY ROAD",
            "address_2": "BLDG. 4076",
            "city": "FT WAINWRIGHT",
            "state": "AK",
            "postal_code": "997037440",
            "telephone_number": "907-361-4000",
            "fax_number": "907-361-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4076 NEELY ROAD",
            "address_2": "BLDG. 4076",
            "city": "FT WAINWRIGHT",
            "state": "AK",
            "postal_code": "997037440",
            "telephone_number": "907-361-4000",
            "fax_number": "907-361-4809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9040 Fitzsimmons Dr",
            "address_purpose": "LOCATION",
            "city": "Joint Base Lewis McChord",
            "state": "WA",
            "postal_code": "98431",
            "country_code": "US",
            "telephone_number": "253-968-0325",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9040 Jackson Ave",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "98431",
            "country_code": "US",
            "telephone_number": "253-968-3774",
            "fax_number": "253-968-3510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9040 Fitzsimmons Dr",
            "address_purpose": "LOCATION",
            "city": "Joint Base Lewis McChord",
            "state": "WA",
            "postal_code": "98431",
            "country_code": "US",
            "telephone_number": "253-968-0325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRISTEN",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-07",
        "last_updated": "2023-08-22",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "33206",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NE",
            "license": "33206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lynn Grinsell Sheridan, M.D.
• Karlene Pimentel Sierra, FNP-BC
• Brando R Sipin
• Gloria Hare Smith, RN
• Jarrod Smith
• Esther Hyun So, RN
• Alexander Junho Song, DDS
• Brittany Rebecca Speers, CNM
• Lisa Louise Stammers, RN
• Megan Stayer, RDH

• Obstetrics & Gynecology Physician in Fort Wainwright, AK
• Providers in Fort Wainwright, AK by specialty
• Obstetrics & Gynecology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.