DR. KENNETH SMITH II (NPI# 1376945261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376945261 |
| Entity Type | Individual |
| Full Name | DR. KENNETH SMITH II |
| Credential | DNP |
| Practice Address |
224 W D. L. Ingram Ave Cannon Afb NM 88103-5103 |
| Mailing Address |
224 W D.l. Ingram Ave Cannon Afb NM 88103-5103 |
| Practice Telephone | 5757841104 |
| Mailing Telephone | 5757841104 |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2018-12-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
APRN66962-NP-C | WV | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629680061 | Kenneth Lee Smith | Licensed Practical Nurse | 4905 Frontier Rd, Garland, TX 75043-3506 | 2020-08-18 |
| 1962067439 | Kenneth George Smith | Ophthalmology | 26 Apple Valley Road, High Rolls, NM 88325 | 2019-05-09 |
| 1568933141 | Kenneth Smith | Pharmacist | 4393 Fielding Ln, Norcross, GA 30092-1647 | 2018-12-08 |
| 1639645203 | Kenneth Smith | Social Worker | 311 S Betty Ln Apt 34, Clearwater, FL 33756-5849 | 2018-10-22 |
| 1487105144 | Kenneth Smith | Counselor | 4041 N High St Ste 300n, Columbus, OH 43214-3200 | 2016-10-18 |
| 1356898480 | Kenneth Smith | Nurse Practitioner | 6480 Se 55th St, Trenton, FL 32693-3019 | 2016-09-07 |
| 1942661897 | Kenneth Smith | Counselor | 26 Cahoon Rd, Apt A, Buzzards Bay, MA 02532-4802 | 2016-03-18 |
| 1043600893 | Kenneth Edward Smith | Counselor | 1125 48th Avenue North, Myrtle Beach, SC 29577 | 2015-02-02 |
| 1982041018 | Kenneth Lee Smith II | Psychiatry & Neurology | 2323 Sandringham Cir, Indianapolis, IN 46214-2396 | 2013-05-30 |
| 1740563634 | Kenneth Wayne Smith | Occupational Therapy Assistant | 12046 W Spring River Ct, Boise, ID 83709-5160 | 2011-09-27 |
| Street Address |
224 W D. L. INGRAM AVE |
| City | CANNON AFB |
| State | NM |
| Zip Code | 88103-5103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346747151 | Isabella Wolak | Pharmacist | 224 D L Ingram Blvd, Cannon Afb, NM 88103 | 2018-04-09 |
| 1225480544 | Stacey Tatro | Dentist | 224 West D.l. Ingram Ave., Bldg 1408, Cannon Afb, NM 88103 | 2016-07-11 |
| 1871965673 | Chad Bryan Carter | Dentist | 224 W Dl Ingram Ave, Sgpd/dental Clinic, Cannon Air Force Base, NM 88103 | 2015-10-20 |
| 1740660836 | Terah Clifford | Dental Hygienist | 224 W Dl Ingram Blvd, Bldg 1408 Dental Clinic, Cannon Afb, NM 88103 | 2015-06-03 |
| 1528452208 | Taylor Bottari | Physician Assistant | 208 W Dl Ingram, Cannon Afb, NM 88103 | 2015-03-20 |
| 1588071328 | Gretchen Evelynn Szymanski | Nurse Practitioner | Cannon Afb, 224 W D.l. Ingram Blvd, Cannon Afb, NM 88103 | 2014-07-14 |
| 1396155206 | Jennifer Brynn Bendokas | Physician Assistant | 224 West Dl Ingram Avenue, Cannon Afb, NM 88103 | 2014-04-30 |
| 1366889487 | Jeremy Michael Strohmayer | General Practice | 511 Chindt Blvd Building 300, 27soss/osm, Cannon Afb, NM 88103 | 2013-05-30 |
| 1356622401 | Matthew John Nielsen | Dentist | 224 W D.l. Ingram, Bld. 1408, Cannon Afb, NM 88103 | 2011-09-02 |
| 1689965485 | Bryan Wade Sixkiller | Optometrist | 27th Somdg, 208 W. Casa Blanca Ave., Apo, AA 88103 | 2011-04-27 |
| Find all providers in zip 88103 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942808126 | Compassion Docs LLC | Nurse Practitioner | 8100 Wyoming Blvd Ne Ste M-4302, Albuquerque, NM 87113-1946 | 2020-10-11 |
| 1598398216 | Melissa Rose Pino | Nurse Practitioner | 10855 Firenze Dr Nw, Albuquerque, NM 87114-5287 | 2020-02-20 |
| 1043857410 | Elizabeth F Baca | Nurse Practitioner | 2502 Marble Ave, Albuquerque, NM 87131-0001 | 2019-12-04 |
| 1386108546 | Patricia Shepard | Nurse Practitioner | 1410 N 8th St Ste B, Carlsbad, NM 88220-3217 | 2019-01-22 |
| 1023255510 | Valencia Family Medicine & Express Care | Nurse Practitioner | 311 S. Los Lentes, Los Lunas, NM 87031 | 2009-01-21 |
| 1356358477 | Mary Louise Blankenship | Nurse Practitioner | 3200 La Orilla Rd Nw, Albuquerque, NM 87120-2742 | 2006-08-02 |
| 1861093825 | Lesley Roller | Nurse Practitioner | 328 Main St Ne, Los Lunas, NM 87031-7454 | 2020-11-05 |
| 1003415753 | Jessica Wood | Nurse Practitioner | 1400 Main St Nw, Los Lunas, NM 87031-4812 | 2020-10-23 |
| 1023620143 | Chona Miller | Nurse Practitioner | 1500 Lomas Blvd Nw, Albuquerque, NM 87104-1200 | 2020-08-19 |
| 1831708924 | Pala Nicole Rivera | Nurse Practitioner | 1110 Pennsylvania St Ne Ste B, Albuquerque, NM 87110-7404 | 2020-07-24 |
| Find all providers with the same taxonomy | ||||
| City | CANNON AFB |
| Zip Code | 88103 |
Please comment or provide details below to improve the information on DR. KENNETH SMITH II.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.