Active NPI
Kellee J Smith, CRNA
- Certified Registered Nurse Anesthetist
- Carroll, IA
National Provider Identifier
1821077140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 111826
- Practice address
- 311 S Clark St
Carroll, IA 51401-3038 - Phone
- (712) 792-3581
- Fax
- (712) 792-2124
- NPI assigned
- Jan 13, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 111826 | IA | Primary |
Addresses
Primary practice location
311 S Clark St
Carroll, IA 51401-3038
Mailing address
311 S Clark St
Carroll, IA 51401-3038
Phone (712) 792-3581
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0472183 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 93.78 of 100
- Quality
- 80.38
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111826 | IA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Manning Regional Healthcare Center | Current | Accepting new patients |
Locations
1550 6th St
Manning, IA 51455
Phone (712) 655-2072
Interoperability endpoints
- ksmith399028@direct.unitypoint.org
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.
-
- Critical Access Hospital
- Manning, IA
- NPI 1467509141
-
- General Acute Care Hospital
- Cedar Rapids, IA
- NPI 1083708226
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386892800000",
"number": "1821077140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 S CLARK ST",
"city": "CARROLL",
"state": "IA",
"postal_code": "514013038",
"telephone_number": "712-792-3581",
"fax_number": "712-792-2124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 S CLARK ST",
"city": "CARROLL",
"state": "IA",
"postal_code": "514013038",
"telephone_number": "712-792-3581",
"fax_number": "712-792-2124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "KELLEE",
"middle_name": "J",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-13",
"last_updated": "2013-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IA",
"license": "111826",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0472183",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Carroll, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.