MS. KATHLEEN W. SMITH (NPI# 1992109755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992109755 |
| Entity Type | Individual |
| Full Name | MS. KATHLEEN W. SMITH |
| Credential | APN |
| Practice Address |
900 Main Street Suite 280 Peoria IL 61636-4688 |
| Mailing Address |
10611 N Sleepy Hollow Rd Peoria IL 61615-1121 |
| Practice Telephone | 3096436118 |
| Practice Fax Number | 3095177476 |
| Mailing Telephone | 3097121363 |
| Mailing Fax Number | 3095177476 |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2020-08-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 209.012013 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528615184 | Kathleen Smith | Nurse Practitioner | 601 Channelside Walk Way Apt 1438, Tampa, FL 33602-6741 | 2019-08-19 |
| 1750869970 | Kathleen Helen Smith | Community/Behavioral Health | 27 Wildwood, Irvine, CA 92604-3341 | 2018-07-31 |
| 1821593138 | Kathleen Marie Smith | Nurse Practitioner | 44456 Brookside Rd, Plymouth, MI 48170-3848 | 2018-03-28 |
| 1700386588 | Kathleen Marie Smith | Registered Nurse | 14289 Burnt Mls, Willis, TX 77318-6791 | 2018-02-18 |
| 1851750160 | Kathleen Christensen Smith | Acupuncturist | 10 S Hanson St Ste 27, Easton, MD 21601-3078 | 2016-02-15 |
| 1861895534 | Kathleen Ann Smith | Pharmacist | 243 S. Prospect St., Nanticoke, PA 18634 | 2014-10-08 |
| 1427334408 | Kathleen Ann Smith | Social Worker | 2239 Nw 19th St, Oklahoma City, OK 73107-3542 | 2011-10-22 |
| 1326323882 | Kathleen Lesh Smith | Massage Therapist | 16306-b Hwy. 84, Chama, NM 87520 | 2011-10-17 |
| 1558675116 | Kathleen H Smith | Pharmacist | 1920 E Beau St, Washington, PA 15301-3188 | 2010-08-05 |
| 1760707764 | Kathleen Smith | Registered Nurse | 14 Shorehaven Blvd, Lake Ronkonkoma, NY 11779-2719 | 2010-04-01 |
| Street Address |
900 MAIN STREET SUITE 280 |
| City | PEORIA |
| State | IL |
| Zip Code | 61636-4688 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962767376 | Aman Deep Singh | Psychiatry & Neurology | 221 Ne Glen Oak Ave. 7 West, Dept. of Psych. and Behavior Health., Peoria, IL 61636 | 2012-07-11 |
| 1932490075 | Christine Ann Wigginton | Radiology | 221 Ne Glen Oak Ave Dept Of, Peoria, IL 61636 | 2011-04-24 |
| 1154856607 | Shubhada Reddy | Psychiatry & Neurology | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2017-04-21 |
| 1649657685 | Nicholas Grieco | Internal Medicine | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2015-04-29 |
| 1659703759 | Dhaval Save | Internal Medicine | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2013-07-31 |
| 1164474755 | Methodist Medical Center of Illinois | General Acute Care Hospital | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2006-05-16 |
| 1871560623 | Minna Jinn O'leary | Psychiatry & Neurology | 221 Ne Glen Oak Ave, Peoria, IL 61636 | 2006-03-01 |
| 1568901544 | Stephanie Ann Sullivan | Nurse Anesthetist, Certified Registered | Unity Point Health Methodist, 221 Ne Glen Oak Avenue, Peoria, IL 61636-0001 | 2017-02-23 |
| 1073066155 | Caroline Vanaman | Counselor | 221 Ne Glen Oak Ave # 7w, Peoria, IL 61636-0001 | 2016-07-26 |
| 1497141758 | Amber Hemminger | Registered Nurse | 200 Ne Glen Oak Ave, Peoria, IL 61636-0001 | 2015-04-13 |
| Find all providers in zip 61636 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962034215 | Lia Doh | Nurse Practitioner | 8357 W Rosewood Ln, Peoria, AZ 85383-3869 | 2020-02-05 |
| 1285274027 | Chauntel M Nessmith | Nurse Practitioner | 7540 W Jenan Dr, Peoria, AZ 85345-1367 | 2020-01-09 |
| 1003450925 | Kimberly Ann Flores | Nurse Practitioner | 12118 W Avenida Del Rey, Peoria, AZ 85383-5819 | 2019-11-04 |
| 1821630666 | Leesa K Jost | Nurse Practitioner | 8914 N Prairie Pointe Rd, Peoria, IL 61615-1574 | 2019-10-14 |
| 1942842018 | Tamarra Lynn Subyantoro | Nurse Practitioner | 5114 N Glen Park Place Rd Ste 110, Peoria, IL 61614-4686 | 2019-10-10 |
| 1255981593 | Eunmee Hong | Nurse Practitioner | 21369 N 79th Dr, Peoria, AZ 85382-4453 | 2019-09-18 |
| 1295297737 | Tasha R Besser | Nurse Practitioner | 5114 N Glen Park Place Rd Ste 220, Peoria, IL 61614-4686 | 2019-04-03 |
| 1669936506 | Kristin Danielle Downs | Nurse Practitioner | 10408 N Centerway Dr, Peoria, IL 61615-1234 | 2019-01-24 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1538665609 | Tara Moore | Nurse Practitioner | 10408 N Centerway Dr Ste Cde, Peoria, IL 61615-1234 | 2018-04-05 |
| Find all providers in PEORIA | ||||
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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.