Active NPI
Keith Dorman Smith
- Private Vehicle
- Colorado Springs, CO
National Provider Identifier
1760838726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- License
- LL-03194
- Practice address
- 2910 N Powers Blvd
Suite 139
Colorado Springs, CO 80922-2801 - Phone
- (719) 232-5240
- NPI assigned
- May 9, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | LL-03194 | CO | Primary |
Addresses
Primary practice location
2910 N Powers Blvd
Suite 139
Colorado Springs, CO 80922-2801
Mailing address
6716 Snowy Range Dr
Colorado Springs, CO 80923-5192
Phone (719) 470-0227
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 |
|---|---|---|---|
| LL-03194 | CO | MD | Private Vehicle |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462752000000",
"number": "1760838726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6716 SNOWY RANGE DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809235192",
"telephone_number": "719-470-0227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2910 N POWERS BLVD",
"address_2": "SUITE 139",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809222801",
"telephone_number": "719-232-5240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORMAN SMITH",
"first_name": "KEITH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-05-09",
"last_updated": "2016-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "CO",
"license": "LL-03194",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.