KRYSTAL S SMITH (NPI# 1447489638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447489638 |
| Entity Type | Individual |
| Full Name | KRYSTAL S SMITH |
| Credential | DO |
| Practice Address |
2500 N State St Jackson MS 39216-4500 |
| Mailing Address |
2055 Normandie Dr Suite 108 Montgomery AL 36111-2732 |
| Practice Telephone | 6014664930 |
| Mailing Telephone | 3342696337 |
| Mailing Fax Number | 3348340657 |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2016-10-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
T-2246 | MS | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
MDDO1578 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | RAILROAD MEDICARE | P01590545 | 01 |
| MS | 05409055 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922611821 | Krystal Smith | Counselor | 13 Hasbrouck Dr Apt E, Garnerville, NY 10923-1644 | 2020-08-28 |
| 1225641541 | Krystal Smith | Behavior Technician | 1330 Quail Lake Loop Ste 200, Colorado Springs, CO 80906-4651 | 2020-08-26 |
| 1992331573 | Krystal Nicole Smith | Nurse Practitioner | 3737 Government Blvd Ste 203, Mobile, AL 36693-4310 | 2020-03-16 |
| 1801366448 | Krystal Smith | Behavior Technician | 1106 Windfield Way Ste 1, El Dorado Hills, CA 95762-9360 | 2018-11-27 |
| 1437689338 | Krystal Smith | Student in an Organized Health Care Education/Training Program | 15501 San Pablo Ave # G239, Richmond, CA 94806-5848 | 2017-06-14 |
| 1568917458 | Krystal Smith | Social Worker | 700 19th St S, Birmingham, AL 35233-1927 | 2016-08-20 |
| 1265829949 | Krystal Smith | Day Training/Habilitation Specialist | 1910 Rector Rd, Paragould, AR 72450-2004 | 2015-04-21 |
| 1902188188 | Krystal Marie Smith | Counselor | 3800 Coolidge Ave, Oakland, CA 94602-3311 | 2011-09-14 |
| 1366775371 | Krystal Lashun Smith | Social Worker | 707 N Broadway, Kennedy Krieger Institute, Baltimore, MD 21205-1832 | 2009-09-09 |
| 1104994425 | Krystal Smith | Specialist/Technologist | 1000 Spring Garden St., 136 Hhp Building, Uncg Athletics, Greensboro, NC 27402-6168 | 2006-12-04 |
| Street Address |
2500 N STATE ST |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556231 | University Ophthalmology Associates | Ophthalmology | 2500 N State St, Ste B329, Jackson, MS 39216-4500 | 2005-05-24 |
| 1396346607 | Ashleigh Renfroe Hannah | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-11-03 |
| 1770182438 | Tara P. Carter | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-10-22 |
| 1679189849 | Raegan Wilson | Registered Nurse | 2500 N State St, Jackson, MS 39216-4500 | 2020-09-22 |
| 1851905095 | Violet Maloba Awori | Student in an Organized Health Care Education/Training Program | 2500 N State St, Jackson, MS 39216-4500 | 2020-09-04 |
| 1295348639 | Kassidy Voinche | Pharmacist | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-25 |
| 1215549423 | Brittney Leeann Williams | Pharmacist | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-19 |
| 1912519364 | Rashmi Verma | Internal Medicine | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-18 |
| 1982215414 | Anita Dhanrajani | Pediatrics | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-10 |
| 1528676954 | Nicholas Mcafee | Psychologist | 2500 N State St, Jackson, MS 39216-4500 | 2020-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376157099 | Kathryn Taylor Parvin | Radiology | 969 Lakeland Dr, Jackson, MS 39216-4699 | 2020-09-01 |
| 1235558537 | Carson Kisner | Radiology | 60 Physicians Dr, Jackson, TN 38305-2070 | 2014-04-15 |
| 1780021170 | Ajinkya Shrinivas Desai | Radiology | 2500 N State St, Jackson, MS 39216-4500 | 2013-05-27 |
| 1538326798 | Aaron Raphael Barnard Brandis | Radiology | 620 Skyline Dr, Jackson, TN 38301-3923 | 2008-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043825540 | Gulf Coast Vascular Care, LLC | Radiology | 14219 Cook Rd, Biloxi, MS 39532-9719 | 2020-09-11 |
| 1093731895 | Vipin S Patel | Radiology | 1010 Lakeland Square Ext Ste B, Flowood, MS 39232-7607 | 2006-07-14 |
| 1023358132 | South Central Regional Medical Center | Radiology | 1410 Jefferson St, Laurel, MS 39440-4243 | 2013-02-26 |
| 1871838490 | Premier Interventional Radiology Clinic | Radiology | 891 Mississippi Dr, Tupelo, MS 38804-0934 | 2012-12-07 |
| 1770832461 | Flowood Vascular Access, LLC | Radiology | 1010 Lakeland Square Ext Ste B, Flowood, MS 39232-7607 | 2012-09-10 |
| 1194048231 | Delta Radiology Pllc | Radiology | 901 E Sunflower Rd, Cleveland, MS 38732-2833 | 2010-03-03 |
| 1083936231 | North Florida Radiological Institute Inc | Radiology | 1401 River Rd, Greenwood, MS 38930-4030 | 2010-02-15 |
| 1851620249 | Vascular Access Center of Bolivar County LLC | Radiology | 810 E Sunflower Rd, Suite 100b, Cleveland, MS 38732-2800 | 2009-12-14 |
| 1962682468 | Meridian Imaging, Pa | Radiology | 1102 Constitution Ave, First Floor, Meridian, MS 39301-4001 | 2007-11-13 |
| 1245306547 | The Vein Center | Radiology | 401 Alcorn Dr, Suite 2a, Corinth, MS 38834-9072 | 2006-11-28 |
| Find all providers with the same taxonomy | ||||
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| 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.