Kelly Lynn Smith, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041289431 Issued in IL

Practice address

1999 Wabash Ave
Springfield, IL 62704-5351

Phone

(217) 523-2273

Fax

(217) 523-2272

NPI assigned

Jan 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1720445166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1999 WABASH AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627045351",
            "telephone_number": "217-523-2273",
            "fax_number": "217-523-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1999 WABASH AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627045351",
            "telephone_number": "217-523-2273",
            "fax_number": "217-523-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-15",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041289431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dontaevez Smith
• Gracye Smith
• Ison David Smith
• Kati Lynn Smith
• Kellsie Lynn Smith, RBT
• Kerri A Smith, ANP
• Kirby G Smith
• Kristin Smith, LPC
• Lawrence J Smith, M.D.
• Matt R Smith

• Registered Nurse in Springfield, IL
• Providers in Springfield, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.