NPIMap

Individual provider Active NPI

Kent C Smith, DO

  • Emergency Medicine Physician
  • Moses Lake, WA
National Provider Identifier
1306873302
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OP0001625 Issued in WA
Practice address
801 E Wheeler Rd
Moses Lake, WA 98837-1820
Phone
(509) 766-1301
Fax
(509) 766-1306
NPI assigned
Jun 26, 2006
Last updated
Apr 1, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OP0001625 WA Primary

Addresses

Primary practice location

801 E Wheeler Rd
Moses Lake, WA 98837-1820

Mailing address

505 S 336TH St
Suite 600
Federal Way, WA 98003-6328
Phone (253) 838-6180

Other identifiers 4

IdentifierTypeStateIssuer
1117SMOtherWABSWA
0223854OtherWALIWA
8011SMOtherWABSWA
8238818MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041221000779 WA Practitioner - Emergency Medicine 9537127675 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Ohio University, College of Osteopathic Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 W Sims Way
Suite C
Port Townsend, WA 98368-3031
Phone (360) 385-6297

834 Sheridan St
Port Townsend, WA 98368-2443
Phone (360) 385-2200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.09 of 100Reported as apm
Quality
68.03
Promoting interoperability
81
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
142NEMDMarriage & Family Therapist
OP0001625WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Klickitat County Public Hospital District No 1 CurrentSince Jun 1, 2025 Accepting new patients
Klickitat County Public Hospital District No 1 Current Accepting new patients
Jefferson County Public Hospital District No 2 CurrentSince Oct 25, 2014 Accepting new patients
Klickitat County Public Hospital District No 1 Current Accepting new patients
Northwest Physician Associates, Apc Emergency Medicine Past Accepting new patients
Northwest Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Tacoma Emergency Medicine Associates PC Emergency Medicine Past Accepting new patients
Clallam County Public Hospital District No 1 Past Accepting new patients

Locations

310 S Roosevelt St
Goldendale, WA 98620
Phone (509) 486-2151

834 Sheridan St
Port Townsend, WA 98368
Phone (360) 344-0400

1200 W Sims Way
Ste C
Port Townsend, WA 98368
Phone (360) 385-6297

934 Sheridan St
Port Townsend, WA 98368
Phone (360) 385-5330

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1306873302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S 336TH ST",
            "address_2": "SUITE 600",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036328",
            "telephone_number": "253-838-6180",
            "fax_number": "253-838-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E WHEELER RD",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371820",
            "telephone_number": "509-766-1301",
            "fax_number": "509-766-1306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KENT",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "OP0001625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "1117SM",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0223854",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "8011SM",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8238818",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moses Lake, WA

Sources for this page

Verify at the official NPI Registry.