Kenneth D Smith, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

R8F26 Issued in MO

Practice address

1101 W Liberty
Parkland Health Center Dept of Radiology
Farmington, MO 63640

Phone

(573) 760-8075

Fax

(573) 760-8358

NPI assigned

Aug 11, 2006

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

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Ste Genevieve County Memorial Hospital

  • Critical Access Hospital
  • Ste Genevieve, MO
  • NPI 1073587655
  Medicare reassignment NPD
• Analytical Pathology Services LTD

  • Anatomic Pathology & Clinical Pathology Physician
  • Saint Louis, MO
  • NPI 1558343673
  NPD

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1316958531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 629",
            "address_2": "SMITH IMAGING INC",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "63640",
            "telephone_number": "573-760-8075",
            "fax_number": "314-821-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 W LIBERTY",
            "address_2": "PARKLAND HEALTH CENTER DEPT OF RADIOLOGY",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "63640",
            "telephone_number": "573-760-8075",
            "fax_number": "573-760-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KENNETH",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "R8F26",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMR",
            "identifier": "235639",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MO",
            "identifier": "945K1",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "14989V14989",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMER MEDSE",
            "identifier": "235639",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "STL1600408",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HL",
            "identifier": "235639",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE",
            "identifier": "8707",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL BLUE",
            "identifier": "945K1",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO BLUE",
            "identifier": "945K1",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derek James Smith, APRN, PMHNP-BC
• James A Smith, RN, CRNA
• Jamesy Charles Smith, D.O.
• Jessica Michelle Smith
• John-Peyton Scott Smith
• Megan Lynn Smith, O.D.
• Morgan Lashay Smith
• Nicole Dawn Smith, BSW
• Gail H Smithmier, L.P.C.
• Southeast Missouri Behavioral Health

• Diagnostic Radiology Physician in Farmington, MO
• Providers in Farmington, MO by specialty
• Diagnostic Radiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.