Sidney Smith

Primary specialty

Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X

License

2160 Issued in KS

Practice address

23401 Prairie Star Pkwy Ste B-300
Lenexa, KS 66227-7268

Phone

(913) 677-6319

NPI assigned

Nov 6, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• KC Bariatric, LLC

  • Surgery Physician
  • Lenexa, KS
  • NPI 1992945307
  Medicare reassignment NPD
• Midwest Anesthesia Associates, PA

  • Anesthesiology Physician
  • Shawnee Mission, KS
  • NPI 1336192392
  NPD (past)

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1962046508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23401 PRAIRIE STAR PKWY STE 300",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662277246",
            "telephone_number": "913-677-6319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23401 PRAIRIE STAR PKWY STE B-300",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662277268",
            "telephone_number": "913-677-6319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SIDNEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-06",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "MO",
            "license": "2018006451",
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "KS",
            "license": "2160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Lenexa",
            "affiliation": "N",
            "address_1": "23401 Prairie Star Pkwy Ste 300",
            "city": "Lenexa",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662277246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karen C Smith, LSCSW
• Madison Smith
• Makayla Smith
• Molly Lynn Smith, LPC
• Sharita Smith
• Taasha Smith, LPC
• Tanise Smith, LPC
• Timesha Smith
• Haleigh Solar
• Ashtin Songster, OD

• Obesity and Weight Management Nutrition Registered Dietitian in Lenexa, KS
• Providers in Lenexa, KS by specialty
• Obesity and Weight Management Nutrition Registered Dietitian in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.