Rodney Travis Smith, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4069P Issued in KY

Practice address

215 Treuhaft Blvd
Suite 2
Barbourville, KY 40906-7361

Phone

(606) 545-0400

Fax

(606) 545-0433

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Barbourville, KY
  • NPI 1255504700

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership

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.

• Memorial Hospital, Inc.

  • Specialist
  • Manchester, KY
  • NPI 1831150119
  Medicare reassignment NPD
• Memorial Hospital Inc.

  • Rural Health Clinic/Center
  • Manchester, KY
  • NPI 1255471827
  NPD
• Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Barbourville, KY
  • NPI 1255504700

  Nurse Practitioner

  NPD
• Memorial Hospital, Inc.

  • Family Medicine Physician
  • Manchester, KY
  • NPI 1912137720

  Nurse Practitioner

  NPD
• Flat Lick Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Flat Lick, KY
  • NPI 1750317491
  NPD (past)
• Southeastern Emergency Services P C

  • Nurse Practitioner
  • Athens, TN
  • NPI 1669414264
  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1699714220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 518",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409060518",
            "telephone_number": "606-545-0400",
            "fax_number": "606-545-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 TREUHAFT BLVD",
            "address_2": "SUITE 2",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409067361",
            "telephone_number": "606-545-0400",
            "fax_number": "606-545-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RODNEY",
        "middle_name": "TRAVIS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4069P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00259831",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78011186",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edwin Earl Smith, DMD
• Kellie Smith, APRN
• Macy Grace Smith
• Melinda Rae Smith, ARNP
• Rebecca Smith, MS CCC-SLP
• Charles V Stargel, MD
• Malissa Dawn Stephens
• Christin Haleigh Sutton
• Garry Joel Swanner II, PA-C
• Holly Ray Taylor-Williams, LPCC-S

• Nurse Practitioner in Barbourville, KY
• Providers in Barbourville, KY by specialty
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.