DR. KINIM I SMITH (NPI# 1275646473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275646473 |
| Entity Type | Individual |
| Full Name | DR. KINIM I SMITH |
| Credential | M.D. |
| Practice Address |
3817 Mcmasters Ave Suite 150 Hannibal MO 63401-2488 |
| Practice Telephone | 5732210304 |
| Practice Fax Number | 5732210308 |
| Mailing Telephone | 5732210304 |
| Mailing Fax Number | 5732210308 |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2015-12-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 119287 | MO | Other Service Providers |
| N | 207R00000X | Internal Medicine | 119287 | MO | Allopathic & Osteopathic Physicians |
| Y | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
119287 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MEDICARE PTAN | MA1381 | 01 |
| MO | 204666317 | 05 | |
| MO | MEDICARE PTAN | 000095293 | 01 |
| Street Address |
3817 MCMASTERS AVE SUITE 150 |
| City | HANNIBAL |
| State | MO |
| Zip Code | 63401-2488 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457503609 | Bowling Green Arthritis & Rheumatology Clinic P C | Internal Medicine | 3817 Mcmasters Ave, Suite 150, Hannibal, MO 63401-2488 | 2008-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255981064 | Amanda Lynn Jennings | Nurse Practitioner | Hannibal Clinic, 100 Medical Drive, Hannibal, MO 63401 | 2019-09-13 |
| 1316452295 | Hannibal Regional Healthcare System, Inc | Hospice Care, Community Based | 6401 Hwy Mm, Hannibal, MO 63401 | 2017-12-13 |
| 1932614351 | Sidney M Johnson | Counselor | 1221 Broadway St, Hannibal, MO 63401 | 2017-12-07 |
| 1316467210 | Jessica Baker | Counselor | 4355 Paris Gravel Road, Hannibal, MO 63401 | 2017-06-21 |
| 1346787066 | Hands Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17 Settlerstrail, Hannibal, MO 63401 | 2017-01-20 |
| 1134571672 | Pamela Barrigar | Social Worker | 4600 Mcmasters Ave, Hannibal, MO 63401 | 2016-07-08 |
| 1639540677 | Jessica Murfin | Speech-Language Pathologist | 544 N Veterans Rd, Hannibal, MO 63401 | 2015-10-16 |
| 1366835639 | Cpo Services, Inc. | Prosthetic/Orthotic Supplier | 8965 Highway 36 Ste 3, Hannibal, MO 63401 | 2015-03-11 |
| 1639324254 | Hannibal Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 118 Steam Boat Bend, Hannibal, MO 63401 | 2008-11-24 |
| 1780856112 | Barbara Belle Smith | Social Worker | 3700 Hwy Mm, Hannibal, MO 63401 | 2008-03-26 |
| Find all providers in zip 63401 | ||||
| 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 |
|---|---|---|---|---|
| 1457503609 | Bowling Green Arthritis & Rheumatology Clinic P C | Internal Medicine | 3817 Mcmasters Ave, Suite 150, Hannibal, MO 63401-2488 | 2008-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376164277 | Rheum Care LLC | Internal Medicine | 1301 Ymca Drive, Suite 600, Festus, MO 63028-2608 | 2020-05-01 |
| 1801216551 | Joshy Thomas Pathiparampil | Internal Medicine | 12700 Southfork Rd Ste 235, Saint Louis, MO 63128-3201 | 2014-04-21 |
| 1700152048 | Ali Medical LLC | Internal Medicine | 300 Medical Plz Ste 100, Lake St Louis, MO 63367-1484 | 2012-03-30 |
| 1740552280 | David M. Lieberman | Internal Medicine | 28 Nantucket Ln, Saint Louis, MO 63132-4137 | 2012-01-30 |
| 1023306040 | Adam Maxwell Parker | Internal Medicine | 12255 Depaul Drive Suite 500, Bridgeton, MO 63044 | 2011-07-11 |
| 1316113467 | Hopkins Rheumatology PC | Internal Medicine | 412 Nw Mock Ave Ste A, Blue Springs, MO 64014-2541 | 2008-05-07 |
| 1932393162 | Celia Jow Fang Lin | Internal Medicine | 1800 S Brentwood Blvd, #1116, Saint Louis, MO 63144-1820 | 2007-08-30 |
| 1275734543 | Melinda Renee Reed | Internal Medicine | 2900 Independence Sq, West Plains, MO 65775-4238 | 2007-05-31 |
| 1942414198 | Ronald Joseph Auclair | Internal Medicine | 460 N Taylor Ave, Kirkwood, MO 63122-4461 | 2007-05-09 |
| 1114014867 | Terry L. Moore | Internal Medicine | 3660 Vista Ave., St. Louis, MO 63110 | 2006-10-06 |
| 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.