Individual provider Active NPI

Stephen Dale Smith, M.D.

  • Pediatric Hematology & Oncology Physician
  • Westwood, KS
National Provider Identifier
1760495402
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
04-17361 Issued in KS
Practice address
2330 Shawnee Mission Parkway
Westwood, KS 66205
Phone
(913) 588-6340
Fax
(913) 588-2245
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 036079523 IL
Pediatric Hematology & Oncology Physician 2080P0207X 04-17361 KS Primary

Addresses

Primary practice location

2330 Shawnee Mission Parkway
Westwood, KS 66205

Mailing address

3901 Rainbow Blvd
University of Kansas Medical Center
Kansas City, KS 66160
Phone (913) 588-6340

Other identifiers 2

IdentifierTypeStateIssuer
100287090BMedicaidKS
036079523MedicaidIL

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036079523ILMDPediatric Hematology & Oncology Physician
04-17361KSMDPediatric Hematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1760495402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "address_2": "UNIVERSITY OF KANSAS MEDICAL CENTER",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "66160",
            "telephone_number": "913-588-6340",
            "fax_number": "913-588-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 SHAWNEE MISSION PARKWAY",
            "city": "WESTWOOD",
            "state": "KS",
            "postal_code": "66205",
            "telephone_number": "913-588-6340",
            "fax_number": "913-588-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHEN",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "IL",
            "license": "036079523",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "KS",
            "license": "04-17361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100287090B",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036079523",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westwood, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.