Individual provider Active NPI

Kristen Diane Smith, M.D.

  • Pediatrics Physician
  • Joliet, IL
National Provider Identifier
1780918540
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
125-055924 Issued in IL
Practice address
2100 Glenwood Ave
Joliet, IL 60435-5487
Phone
(815) 725-2121
NPI assigned
Sep 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01096117A IN
Hospitalist Physician 208M00000X 01096117A IN
Pediatrics Physician 208000000X 125-055924 IL Primary

Addresses

Primary practice location

2100 Glenwood Ave
Joliet, IL 60435-5487

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other practice location 1

12750 Saint Francis Dr
Crown Point, IN 46307-0264
Phone (219) 757-6005

Other identifiers 1

IdentifierTypeStateIssuer
036130223MedicaidIL

Other names 1

  • Dr. Kristen Diane McCord Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kmccordsmith5071@direct.edward.org
Direct Messaging Address kristen.smith@dulyhealthandcare.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250702000788 IN Practitioner - HospitalistPractitioner - Pediatric Medicine 3173837184 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125-055924ILMDPediatrics Physician
01096117AINMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Jul 1, 2025 Accepting new patients
Franciscan Physician Network CurrentSince Jul 1, 2025 Accepting new patients

Locations

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

12750 Saint Francis Dr
Crown Point, IN 46307
Phone (219) 738-2100

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1780918540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 GLENWOOD AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355487",
            "telephone_number": "815-725-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12750 Saint Francis Dr",
            "address_purpose": "LOCATION",
            "city": "Crown Point",
            "state": "IN",
            "postal_code": "463070264",
            "country_code": "US",
            "telephone_number": "219-757-6005",
            "fax_number": "219-681-6823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRISTEN",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-28",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01096117A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01096117A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125-055924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036130223",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmccordsmith5071@direct.edward.org",
            "affiliation": "N",
            "address_1": "2100 Glenwood Ave",
            "city": "Joliet",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604355487",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristen.smith@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "2100 Glenwood Ave",
            "city": "Joliet",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604355487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "MCCORD",
            "middle_name": "DIANE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.