MR. KENNETH A SMITH (NPI# 1003907304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003907304 |
| Entity Type | Individual |
| Full Name | MR. KENNETH A SMITH |
| Credential | MD |
| Practice Address |
1234 East Dupont Road Suite 5 Fort Wayne IN 46825 |
| Mailing Address |
1234 East Dupont Road Suite 1 Fort Wayne IN 46825 |
| Practice Telephone | 2604891666 |
| Practice Fax Number | 2604893255 |
| Mailing Telephone | 2603739728 |
| Mailing Fax Number | 2604595664 |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2012-08-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
01022346 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ANTHEM | 000000206530 | 01 | |
| IN | ANTHEM | 000000637485 | 01 |
| AETNA | 4351567 | 01 | |
| M PLAN | 000000006713 | 01 | |
| IN | 200092670 | 05 | |
| PHP | 1866 | 01 | |
| IN | 100108770A | 05 | |
| IN | R.R. MEDICARE | P00786840 | 01 |
| 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 |
| 1376945261 | Kenneth Smith II | Nurse Practitioner | 224 W D. L. Ingram Ave, Cannon Afb, NM 88103-5103 | 2014-09-23 |
| 1982041018 | Kenneth Lee Smith II | Psychiatry & Neurology | 2323 Sandringham Cir, Indianapolis, IN 46214-2396 | 2013-05-30 |
| Street Address |
1234 EAST DUPONT ROAD SUITE 5 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316065766 | Rheumatology Associates LLC | Internal Medicine | 1234 East Dupont Road, Suite 5, Fort Wayne, IN 46825-1545 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
| 1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
| 1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
| 1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
| 1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1336695782 | Nadine Rene' Handy | Nurse Practitioner | 3978 New Vision Dr., Fort Wayne, IN 46825 | 2016-08-26 |
| 1558815712 | Nathan Paul Miller | Physical Therapist | 10006 Auburn Park Dr, Fort Wayne, IN 46825 | 2016-08-05 |
| 1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
| 1003276643 | Seiss, LLC | Psychologist | 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 | 2016-02-24 |
| Find all providers in zip 46825 | ||||
| Taxonomy Code | 207RR0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Rheumatology |
| An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619178811 | Monica Reddy | Internal Medicine | 7916 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2007-05-29 |
| 1316065766 | Rheumatology Associates LLC | Internal Medicine | 1234 East Dupont Road, Suite 5, Fort Wayne, IN 46825-1545 | 2007-03-26 |
| 1427173517 | Fort Wayne Rheumatology | Internal Medicine | 7910 W Jefferson Blvd, Suite 312, Fort Wayne, IN 46804-4159 | 2007-03-20 |
| 1023109345 | David A Campbell | Internal Medicine | 11141 Parkview Plaza Dr, Suite 310, Fort Wayne, IN 46845-1713 | 2006-09-28 |
| 1619984341 | Marc Wooten | Internal Medicine | 2121 Lake Ave, Department of Veterans Affairs (11), Fort Wayne, IN 46805-5100 | 2006-08-02 |
| 1649216391 | Anil K Rao | Internal Medicine | 7916 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2006-06-21 |
| 1922075084 | Karen R. Ringwald | Internal Medicine | 7916 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2006-03-07 |
| 1992771257 | Steven D. Ko | Internal Medicine | 7916 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2006-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477047256 | American Arthritis & Rheumatology Associates In LLC | Internal Medicine | 18077 River Rd Ste 206, Noblesville, IN 46062-8334 | 2018-06-15 |
| 1457708000 | Union Associated Physicians Clinic, LLC | Internal Medicine | 1711 N 6th 1/2 St Ste 302, Terre Haute, IN 47804-2770 | 2016-05-24 |
| 1972855138 | Rheumetology Arthritis Immunology | Internal Medicine | 4933 Plaza East Blvd, Evansville, IN 47715-2813 | 2012-10-11 |
| 1407167273 | Anan Bassam Afaneh | Internal Medicine | 6905 E 96th St Ste 300, Indianapolis, IN 46250-4456 | 2010-06-28 |
| 1306161955 | Kirk Jenkins | Internal Medicine | 1461 Morthland Dr Ste A, Valparaiso, IN 46385-6362 | 2010-04-06 |
| 1053598896 | Tracy M. Brenner | Internal Medicine | 8902 N Meridian St #210, Indianapolis, IN 46260-5307 | 2008-01-23 |
| 1528248242 | Reddy Rheumatology of Northwest In PC | Internal Medicine | 118 E 90th Drive, Merrillville, IN 46410-7160 | 2007-11-09 |
| 1700927811 | Arthritis Care of Michiana LLC | Internal Medicine | 100 Navarre Pl Ste 5570, South Bend, IN 46601-1169 | 2007-02-09 |
| 1538225487 | Kimberly Shaw Lamberson | Internal Medicine | 1001 West 10th Street, Wishard Hospital, Indianapolis, IN 46202 | 2006-12-28 |
| 1134202880 | William Parker Rusche | Internal Medicine | 3316 E Mulberry Dr, Bloomington, IN 47401-2426 | 2006-10-23 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46825 |
Please comment or provide details below to improve the information on MR. KENNETH A SMITH.
| 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.