Keiren Donovan Smith, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

027131 Issued in CT

Practice address

9 Wheatstone Rd
Madison, CT 06443-8209

Phone

(203) 421-8358

Fax

(203) 421-8358

NPI assigned

Mar 1, 2010

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

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1267401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267401600000",
    "number": "1366764680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 WHEATSTONE RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064438209",
            "telephone_number": "203-421-8358",
            "fax_number": "203-421-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 WHEATSTONE RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064438209",
            "telephone_number": "203-421-8358",
            "fax_number": "203-421-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KEIREN",
        "middle_name": "DONOVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-01",
        "last_updated": "2010-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "027131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lyn Shultis
• Lillian Siegel, CNM
• Marisa Kelsey Sierra, LMFT
• Joseph M Slater, P.A.
• Adrienne G Smaller, PH.D.
• Allison E. Solecki, OTR
• Southern CT Christian Network
• Madison Sparago
• Speech of Madison, LLC
• Claire Abigail Spinks, COTA

• Internal Medicine Physician in Madison, CT
• Providers in Madison, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2010; 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.