Individual provider Active NPI

Kirsten Kalley Smith, CHW

  • Community Health Worker
  • Bemidji, MN
National Provider Identifier
1912821307
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
705 5TH St NW Ste A2
Bemidji, MN 56601-0030
Phone
(218) 444-2718
Fax
(651) 383-4937
NPI assigned
Aug 7, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

705 5TH St NW Ste A2
Bemidji, MN 56601-0030

Mailing address

15855 Main Ave
280
Red Lake, MN 56671-0280
Phone (218) 679-3228

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

NPI Registry JSON

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

{
    "created_epoch": "1786060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1912821307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15855 MAIN AVE",
            "address_2": "280",
            "city": "RED LAKE",
            "state": "MN",
            "postal_code": "566710280",
            "telephone_number": "218-679-3228",
            "fax_number": "651-383-4937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 5TH ST NW STE A2",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566010030",
            "telephone_number": "218-444-2718",
            "fax_number": "651-383-4937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIRSTEN",
        "middle_name": "KALLEY",
        "credential": "CHW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-07",
        "last_updated": "2026-08-07",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.