Kathleen Smith

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

563628-01 Issued in NY

Practice address

412 Peters Blvd
Brightwaters, NY 11718-1809

Phone

(631) 678-6319

NPI assigned

Jun 30, 2022

Sex

Female

Sole proprietor

Yes

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

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989

Interoperability endpoints

• Direct secure messaging: ksmith26505@northwell.direct-ci.com

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1346972056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 PETERS BLVD",
            "city": "BRIGHTWATERS",
            "state": "NY",
            "postal_code": "117181809",
            "telephone_number": "631-678-6319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 PETERS BLVD",
            "city": "BRIGHTWATERS",
            "state": "NY",
            "postal_code": "117181809",
            "telephone_number": "631-678-6319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATHLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "NY",
            "license": "563628-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Ann Schiavone, LCSW-R
• Schwartz Gynecologic Oncology, PLLC
• Benjamin Michael Schwartz, MD
• Marianne Conrad Scifo, MS LSP CCC
• Melanie Simon, OTR/L
• Kristin Michelle Stawiarski, M.D.
• Laura Thompson Steel, MD
• Suffolk Gynecologic Oncology Management
• Sunshine Within Mental Health Counseling, PLLC
• Mabel Thomas, MS

• All providers in Brightwaters, NY
• Lactation Consultant (Registered Nurse) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.