Organization Active NPI

Kenneth R Smith MD

Doing business as Internal Medicine of Bridgeville

  • Internal Medicine Physician
  • Bridgeville, DE
National Provider Identifier
1891849964
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C1-0003941 Issued in DE
Legal business name
KENNETH R SMITH MD
Doing business as
Internal Medicine of Bridgeville
Practice address
8991 Redden Rd
Bridgeville, DE 19933-4746
Phone
(302) 337-3300
Fax
(302) 337-8072
NPI assigned
Jan 23, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kenneth R Smith, MDNPI 1316029077
Title
Owner
Phone
(302) 337-3300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C1-0003941 DE Primary

Addresses

Primary practice location

8991 Redden Rd
Bridgeville, DE 19933-4746

Mailing address

8991 Redden Rd
Bridgeville, DE 19933-4746
Phone (302) 337-3300

Other names 1

  • Internal Medicine of Bridgeville Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
08D0861879Kenneth R Smith MD8991 Redden Rd, Bridgeville, DE 19933Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Internal Medicine of Bridgeville2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891849964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8991 REDDEN RD",
            "city": "BRIDGEVILLE",
            "state": "DE",
            "postal_code": "199334746",
            "telephone_number": "302-337-3300",
            "fax_number": "302-337-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8991 REDDEN RD",
            "city": "BRIDGEVILLE",
            "state": "DE",
            "postal_code": "199334746",
            "telephone_number": "302-337-3300",
            "fax_number": "302-337-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH R SMITH MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-337-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0003941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Internal Medicine of Bridgeville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeville, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.