Richard Keane Smith, PHD CRC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY13809 Issued in CA

Practice address

9775 Mockingbird Ave
Apple Valley, CA 92308

Phone

(760) 240-3217

Fax

(760) 240-3274

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Foothills Psychological Services IncGroup PAC ID 9436157534, 37 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Foothills Psychological Services, Inc.

  • Psychologist
  • Upland, CA
  • NPI 1336121888
  Medicare reassignment Care Compare group NPD
• Back in the Saddle Inc

  • Community Health Clinic/Center
  • Apple Valley, CA
  • NPI 1821282161
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982781084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6037 EASTWOOD AVENUE",
            "city": "ALTA LOMA",
            "state": "CA",
            "postal_code": "91737",
            "telephone_number": "760-240-3217",
            "fax_number": "760-240-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9775 MOCKINGBIRD AVE",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "92308",
            "telephone_number": "760-240-3217",
            "fax_number": "760-240-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RICHARD",
        "middle_name": "KEANE",
        "name_prefix": "Dr.",
        "credential": "PHD CRC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Katherine Smith
• Chasidy Gabrielle Smith
• Grady Sullivan Smith
• Jaleeza Smith
• Jameka Janelle Smith, BA
• Jennifer Marie Smithson
• Brooke Ann Snow, FNP
• Ashlie Lee Snowdale
• Pamela D. Snowden
• Colleen Mary Snyder, F.N.P.

• Clinical Psychologist in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.