Individual provider Active NPI

Kendall Spencer Smith, FNP

  • Family Nurse Practitioner
  • Fayetteville, NC
National Provider Identifier
1558817072
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5008758 Issued in NC
Practice address
1463 Pamalee Dr
Fayetteville, NC 28303-3974
Phone
(910) 482-3000
NPI assigned
Aug 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5008758 NC Primary

Addresses

Primary practice location

1463 Pamalee Dr
Fayetteville, NC 28303-3974

Mailing address

1463 Pamalee Dr
Fayetteville, NC 28303-3974

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20161024000230 NC Practitioner - Nurse Practitioner 5698053817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
George Washington University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

113 S Pine St
Warsaw, NC 28398-1924
Phone (919) 293-7246

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5008758NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Medical Center Incorporated Current Accepting new patients
Goshen Medical Center, Incorporated Current Accepting new patients
Goshen Medical Center Incorporated CurrentSince Apr 11, 2020 Accepting new patients
Goshen Medical Center Incorporated CurrentSince Apr 11, 2020 Accepting new patients
Goshen Medical Center, Incorporated Past Accepting new patients
Goshen Medical Center Incorporated Past Accepting new patients

Locations

400 Mercer Mill Rd
Elizabethtown, NC 28337
Phone (910) 862-5300

444 SW Center St
Faison, NC 28341
Phone (910) 267-0421

325 NC Highway 55 W
Mount Olive, NC 28365
Phone (919) 658-5900

113 S Pine St
Warsaw, NC 28398
Phone (910) 293-7246

Interoperability endpoints

  • Direct secure messaging: kendalls@goshenmedical.cloudcraftdirect.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1558817072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1463 PAMALEE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1463 PAMALEE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033974",
            "telephone_number": "910-482-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KENDALL",
        "middle_name": "SPENCER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-26",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.