Individual provider Active NPI

Kathryn Smith, PHD

  • Psychologist
  • Madison, WI
National Provider Identifier
1922996727
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5395-57 Issued in WI
Practice address
3113 W Beltline Hwy Ste 300
Madison, WI 53713-2934
Phone
(608) 819-6810
Fax
(608) 819-6811
NPI assigned
Jun 27, 2025
Last updated
Jun 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 5395-57 WI Primary

Addresses

Primary practice location

3113 W Beltline Hwy Ste 300
Madison, WI 53713-2934

Mailing address

1161 Lake Cook Rd
Deerfield, IL 60015-5649
Phone (847) 498-5437

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
5395-57WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
KGH Consultation & Treatment, Inc. CurrentSince Jun 29, 2025 Accepting new patients

Locations

1161 Lake Cook Rd
Deerfield, IL 60015
Phone (224) 284-2240

3113 W Beltline Hwy
Ste 300
Madison, WI 53713
Phone (608) 819-6810

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1750982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1922996727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 LAKE COOK RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155649",
            "telephone_number": "847-498-5437",
            "fax_number": "847-498-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 W BELTLINE HWY STE 300",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537132934",
            "telephone_number": "608-819-6810",
            "fax_number": "608-819-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATHRYN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-27",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "5395-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; 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.