Kenneth Smith II, DNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

63613 Issued in NM

Practice address

15301 Warren Shingle Rd
Beale Afb, CA 95903-1905

Phone

(530) 634-4623

NPI assigned

Sep 23, 2014

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

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1376945261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15301 WARREN SHINGLE RD BLDG 5700",
            "city": "BEALE AFB",
            "state": "CA",
            "postal_code": "959031905",
            "telephone_number": "530-634-4114",
            "fax_number": "530-634-4763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15301 WARREN SHINGLE RD",
            "city": "BEALE AFB",
            "state": "CA",
            "postal_code": "959031905",
            "telephone_number": "530-634-4623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-23",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NM",
            "license": "63613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Bryan Serrano, DNP, FNP-C,BSN, RNBC
• Michael A Shaub, M.D.
• Caleb Hunter Shepard, PSY.D.
• Mario Alfredo Silva, MD
• Matthew Simmons, APRN
• Tyler Joseph Smith, D.M.D.
• Meghan Magley Steinour, MD
• Hadley Stephens, MSN, APRN, FNP-BC
• Sarah J Stringer, MD
• Meredith Studer, DPT

• Primary Care Nurse Practitioner in Beale Afb, CA
• Providers in Beale Afb, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; 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.