NPIMap

Individual provider Active NPI

Kyle Smith, M.D.

  • Anesthesiology Physician
  • Bowling Green, KY
National Provider Identifier
1568775310
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
48055 Issued in KY
Practice address
1801 Ashley Cir
Bowling Green, KY 42104-3362
Phone
(615) 327-4304
NPI assigned
Jul 22, 2010
Last updated
Jun 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 48055 KY Primary
Anesthesiology Physician 207L00000X 244954 MA

Addresses

Primary practice location

1801 Ashley Cir
Bowling Green, KY 42104-3362

Mailing address

110 29TH Ave N
Ste 202
Nashville, TN 37203-1401
Phone (615) 327-4304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, KY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140826001201 VA Practitioner - Anesthesiology 9234357781 Reassigns benefits to 2 organizations
I20150615002215 KY Practitioner - Anesthesiology 9234357781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13710 St Francis Blvd
Midlothian, VA 23114-3267
Phone (516) 370-3858

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
244954MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Virginia, PC Anesthesiology CurrentSince Nov 1, 2022 Accepting new patients
Living Well Healthcare, LLC CurrentSince Mar 10, 2016 Accepting new patients
American Anesthesiology of Virginia PC Anesthesiology Current Accepting new patients

Locations

801 N Main St
Tompkinsville, KY 42167
Phone (270) 407-5052

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

13710 St Francis Blvd
Midlothian, VA 23114
Phone (804) 594-7300

Organizations & group practices 4

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.

Hospital & facility affiliations 11

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": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1568775310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 29TH AVE N",
            "address_2": "STE 202",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031401",
            "telephone_number": "615-327-4304",
            "fax_number": "615-327-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 ASHLEY CIR",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043362",
            "telephone_number": "615-327-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KYLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-22",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "48055",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "244954",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.