Kenneth Ronald Smith, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

MDR3K38 Issued in MO

Practice address

1155 W Parkview St
Suite 2D
Bolivar, MO 65613-8279

Phone

(417) 777-2663

Fax

(417) 777-2666

NPI assigned

Aug 16, 2006

Last updated

Dec 10, 2015By the provider in NPPES

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 MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Orthopedic Surgery

Education

University of Kansas School of Med (KC/Wich/Sal), 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Citizens Memorial HealthcareGroup PAC ID 4183528169, 144 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Citizens Memorial Hospital Hospital, Bolivar, MO, CCN 260195

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Citizens Memorial Health Care Foundation

  dba Citizens Memorial Hospice

  • Community Based Hospice Care Agency
  • Bolivar, MO
  • NPI 1124157169

  Corporate Director

  CMS ownership
• Citizens Memorial Health Care Foundation

  dba Colonial Springs Healthcare Center

  • Skilled Nursing Facility
  • Buffalo, MO
  • NPI 1346229481

  Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

  CMS ownership
• Citizens Memorial Health Care Foundation

  dba Citizens Memorial Home Health

  • Home Health Agency
  • Bolivar, MO
  • NPI 1376672238

  Corporate Director

  CMS ownership
• Citizens Memorial Health Care Foundation

  dba Parkview Health Care Facility

  • Skilled Nursing Facility
  • Bolivar, MO
  • NPI 1629057765

  Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

  CMS ownership
• Citizens Memorial Health Care Foundation

  dba Community Springs Healthcare Facility

  • Skilled Nursing Facility
  • El Dorado Springs, MO
  • NPI 1942289095

  Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

  CMS ownership

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

• Citizens Memorial Healthcare

  • Surgery Physician
  • Bolivar, MO
  • NPI 1568566131

  Orthopaedic Surgery

  Medicare reassignment Care Compare group NPD
• Citizens Memorial Healthcare

  dba CMH Willard Medical Center

  • Rural Health Clinic/Center
  • Willard, MO
  • NPI 1568127397
  NPD
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Citizens Memorial Hospital District

  dba Citizens Memorial Hospital

  • General Acute Care Hospital
  • Bolivar, MO
  • NPI 1003981549
  Care Compare affiliation

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449705600000",
    "number": "1508979477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133011",
            "telephone_number": "417-326-6000",
            "fax_number": "417-328-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 W PARKVIEW ST",
            "address_2": "SUITE 2D",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656138279",
            "telephone_number": "417-777-2663",
            "fax_number": "417-777-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KENNETH",
        "middle_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2015-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "MDR3K38",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Lea Skopec, COTA
• Sarah Marie Slama, PHARM-D
• Jeffrey K Smieshek, D.O.
• Smith Management Services, LLC (Family Pharmacy #20)
• Amanda K Smith
• Lynetta S Smith, MS, RDN, LD
• Thomas James Sneed, DPT
• Southern Light Community Counseling
• Southern Light Residential
• Southwest Ozark Optometric Physicians Inc

• Orthopaedic Surgery Physician in Bolivar, MO
• Providers in Bolivar, MO by specialty
• Orthopaedic Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.