Individual provider Active NPI

Kimberly Ruth Smith, RN, BSN, CLC

  • Student in an Organized Health Care Education/Training Program
  • Donnelly, ID
National Provider Identifier
1730009879
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
16 Timberline Dr
Donnelly, ID 83615-5500
Phone
(208) 805-7296
NPI assigned
Jul 20, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X ID Primary

Addresses

Primary practice location

16 Timberline Dr
Donnelly, ID 83615-5500

Mailing address

16 Timberline Dr
Donnelly, ID 83615-5500

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

NPI Registry JSON

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

{
    "created_epoch": "1784505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1730009879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 TIMBERLINE DR",
            "city": "DONNELLY",
            "state": "ID",
            "postal_code": "836155500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 TIMBERLINE DR",
            "city": "DONNELLY",
            "state": "ID",
            "postal_code": "836155500",
            "telephone_number": "208-805-7296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIMBERLY",
        "middle_name": "RUTH",
        "credential": "RN, BSN, CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-20",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Donnelly, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; 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.