Kenneth B Smith, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

R7025 Issued in MO

Practice address

901 Patients First Dr
Washington, MO 63090-4700

Phone

(636) 239-7500

Fax

(636) 239-2836

NPI assigned

Jun 23, 2006

Last updated

Feb 9, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ksmith76884@directc.mercy.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mercy Clinic East Communities

  • Family Medicine Physician
  • Saint Louis, MO
  • NPI 1043574940

  Internal Medicine

  Medicare reassignment NPD
• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1073739041
  NPD
• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228
  NPD
• Patients First Health Care LLC

  • Internal Medicine Physician
  • Washington, MO
  • NPI 1962441386
  NPD
• Mercy Clinic Adult Critical Care, LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Saint Louis, MO
  • NPI 1730119421
  NPD (past)
• Patients First Health Care LLC

  • Cardiovascular Disease Physician
  • Fenton, MO
  • NPI 1356581078
  NPD (past)
• St. John's Mercy Support Services

  • Cardiovascular Disease Physician
  • Washington, MO
  • NPI 1912020397
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1801822747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 PATIENTS FIRST DR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904700",
            "telephone_number": "636-239-7500",
            "fax_number": "636-239-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 PATIENTS FIRST DR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904700",
            "telephone_number": "636-239-7500",
            "fax_number": "636-239-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KENNETH",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R7025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202116802",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01135273",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110166321",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Simmons Chiropractic LLC (Washington Wellness Center)
• John M Simmons, D.C.
• Charles Harvey Sincox, M.D.
• Meghan Elizabeth Skief, FNP
• Amanda M Smith, MD
• Melissa Ann Smith, DDS
• Michelle Smith
• Jessica Lynn Sneed, MOTR/L
• Stephanie Ann Souris, FNP-C
• Southeast Missouri Community Treatment Center, Inc.

• Internal Medicine Physician in Washington, MO
• Providers in Washington, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.