Individual provider Active NPI

Walter Darnell Smith, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Louis, MO
National Provider Identifier
1669616686
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
153185 Issued in MO
Practice address
10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone
(636) 386-7222
Fax
(636) 200-4036
NPI assigned
Apr 21, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 153185 MO
Certified Registered Nurse Anesthetist 367500000X 153185 MO Primary

Addresses

Primary practice location

10010 Kennerly Rd
Saint Louis, MO 63128-2106

Mailing address

915 N Grand Blvd
Saint Louis, MO 63106-1621
Phone (314) 652-4100

Other practice location 1

915 N Grand Blvd
Saint Louis, MO 63106-1621
Phone (314) 652-4100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090618000530 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466502141 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
153185MOMDRegistered Nurse

Organizations & group practices 1

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": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1669616686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 N GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631061621",
            "telephone_number": "314-652-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "636-386-7222",
            "fax_number": "636-200-4036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 N Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631061621",
            "country_code": "US",
            "telephone_number": "314-652-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WALTER",
        "middle_name": "DARNELL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-21",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "153185",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "153185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.