Keirsten E Smith, M.D.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

430111666 Issued in MI

Practice address

145 4TH Ave NE
Family Practice/ Sports Medicine
Gladstone, MI 49837

Phone

(906) 428-3273

Fax

(906) 428-1881

NPI assigned

May 29, 2014

Last updated

Feb 4, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Keirsten Davio Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Family PracticeAlso: Sports Medicine

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Francis HospitalGroup PAC ID 5991604753, 85 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf St Francis Hospital Home Health Care Home health agency, Escanaba, MI, CCN 237239
• Osf St Francis Hospital and Medical Group Hospital, Escanaba, MI, CCN 231337
• Schoolcraft Memorial Hospital Hospital, Manistique, MI, CCN 231303

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St. Francis Hospital

  dba OFSMG - Women's Center

  • Obstetrics & Gynecology Physician
  • Escanaba, MI
  • NPI 1700828837
  Medicare reassignment Care Compare group NPD
• St Francis Hospital

  dba St. Francis Professional Services

  • Anatomic Pathology & Clinical Pathology Physician
  • Escanaba, MI
  • NPI 1932206455
  NPD
• St. Francis Hospital

  dba OSFMG Escanaba Gladstone Powers

  • Family Medicine Physician
  • Escanaba, MI
  • NPI 1629011622
  NPD
• St Francis Hospital

  dba OSF Healthcare St. Francis Hospital & Medical Group

  • Critical Access Hospital
  • Escanaba, MI
  • NPI 1922058551
  NPD (past)

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

• Schoolcraft Memorial Hospital

  • Critical Access Hospital
  • Manistique, MI
  • NPI 1700805157
  Care Compare affiliation
• St Francis Hospital

  dba OSF St. Francis Hospital Home Health Care

  • Home Health Agency
  • Escanaba, MI
  • NPI 1033157037
  Care Compare affiliation
• St Francis Hospital

  dba OSF Healthcare St. Francis Hospital & Medical Group

  • Critical Access Hospital
  • Escanaba, MI
  • NPI 1922058551
  Care Compare affiliation

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1679985311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 4TH AVE NE",
            "address_2": "FAMILY PRACTICE/ SPORTS MEDICINE",
            "city": "GLADSTONE",
            "state": "MI",
            "postal_code": "49837",
            "telephone_number": "906-428-3273",
            "fax_number": "906-428-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 4TH AVE NE",
            "address_2": "FAMILY PRACTICE/ SPORTS MEDICINE",
            "city": "GLADSTONE",
            "state": "MI",
            "postal_code": "49837",
            "telephone_number": "906-428-3273",
            "fax_number": "906-428-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KEIRSTEN",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-29",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD36202",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "L4014R",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301116666",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MI",
            "license": "430111666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679985311",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEIRSTEN",
            "last_name": "DAVIO",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew Rayeski, DO
• Erik M Rubright, DO
• Joann Leano Santos
• Sierra Schiller, RN
• John Wurth Skellenger, DDS
• Speak U.P. Speech Therapy
• St Francis Hospital (ST FRANCIS HOSPITAL - Gladstone)
• Leslie Joeanna Stanek-Nault, LPC
• Transition Assisted Living, LLC
• Jaren Trotter

• Sports Medicine (Family Medicine) Physician in Gladstone, MI
• Providers in Gladstone, MI by specialty
• Sports Medicine (Family Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.