Kenneth Roger Smith, CCSS

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

2004 Valencia Dr NE
Albuquerque, NM 87110-5210

Phone

(505) 398-7843

NPI assigned

Mar 22, 2023

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Turning Point Detox, LLC

  • Substance Abuse Rehabilitation Facility
  • Albuquerque, NM
  • NPI 1497171185
  NPD (past)

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1447953237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 VALENCIA DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105210",
            "telephone_number": "505-398-7843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 VALENCIA DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105210",
            "telephone_number": "505-398-7843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KENNETH",
        "middle_name": "ROGER",
        "credential": "CCSS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Ann Smith, RN
• Katherine Smith
• Katrina Smith, LMT
• Kendra Smith
• Kenneth J Smith, MD
• Kim Smith, PHD
• Kimberly D Smith, CNNP
• Kristina Smith, APRN
• Laura Lee Smith
• Laura Louise Smith, PH.D.

• Community Health Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Community Health Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; 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.