Active NPI
Kayla Sarina Smithback, DPT
- Skilled Nursing Facility
- Elkhorn, WI
National Provider Identifier
1699210286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 13044
- Practice address
- 645 N Church St
Elkhorn, WI 53121-2204 - Phone
- (262) 723-4963
- NPI assigned
- Jan 5, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 13044 | WI | Primary |
Addresses
Primary practice location
645 N Church St
Elkhorn, WI 53121-2204
Mailing address
2900 Root River Pkwy
West Allis, WI 53227-2924
Phone (608) 217-9907
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13044 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1483574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483574400000",
"number": "1699210286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2900 ROOT RIVER PKWY",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532272924",
"telephone_number": "608-217-9907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "645 N CHURCH ST",
"city": "ELKHORN",
"state": "WI",
"postal_code": "531212204",
"telephone_number": "262-723-4963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITHBACK",
"first_name": "KAYLA",
"middle_name": "SARINA",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-05",
"last_updated": "2017-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "WI",
"license": "13044",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkhorn, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.