Individual provider Active NPI

Kortni Danielle Smith, DC

  • Chiropractor
  • Clinton, IA
National Provider Identifier
1538765508
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
106358 Issued in IA
Practice address
1608 S 19TH St
Clinton, IA 52732-6702
Phone
(563) 242-2002
NPI assigned
Dec 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 106358 IA Primary

Addresses

Primary practice location

1608 S 19TH St
Clinton, IA 52732-6702

Mailing address

1608 S 19TH St
Clinton, IA 52732-6702
Phone (563) 242-2002

Other names 1

  • Kortni Richards Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201230002699 IA Practitioner - Chiropractic 8426461989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1608 S 19TH St
Clinton, IA 52732-6702
Phone (563) 242-2002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106358IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Muscle & Spine Chiropractic Clinic Inc Chiropractor CurrentSince Dec 3, 2020 Accepting new patients
Todd M Slattery P C Chiropractor PastSince Dec 3, 2020 Accepting new patients

Locations

1608 S 19th St
Clinton, IA 52732
Phone (563) 242-2002

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1538765508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 S 19TH ST",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527326702",
            "telephone_number": "563-242-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 S 19TH ST",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527326702",
            "telephone_number": "563-242-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KORTNI",
        "middle_name": "DANIELLE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-07",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "106358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KORTNI",
            "last_name": "RICHARDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clinton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.