DR. KATHLEEN JEANNE SMITH (NPI# 1396916219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396916219 |
| Entity Type | Individual |
| Full Name | DR. KATHLEEN JEANNE SMITH |
| Credential | MD |
| Practice Address |
1670 Scott Blvd Ste 202 Decatur GA 30033-5645 |
| Practice Telephone | 6789044932 |
| Practice Fax Number | 4704282869 |
| Mailing Telephone | 6789044932 |
| Mailing Fax Number | 4704282869 |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2016-10-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 053035 | GA | Allopathic & Osteopathic Physicians |
| Y | 207ZD0900X |
Pathology Specialization: Dermatopathology |
053035 | GA | Allopathic & Osteopathic Physicians |
| N | 207ZI0100X |
Pathology Specialization: Immunopathology |
053035 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 090074158A | 05 | |
| GA | WELLCARE | 460052 | 01 |
| 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 |
| 1992109755 | Kathleen W. Smith | Nurse Practitioner | 900 Main Street Suite 280, Peoria, IL 61636-4688 | 2014-10-22 |
| 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 |
| Street Address |
1670 SCOTT BLVD STE 202 |
| City | DECATUR |
| State | GA |
| Zip Code | 30033-5645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922613785 | Healing Minds, Helping Hearts, LLC | Social Worker | 2532 N Decatur Rd, Apt 1304, Decatur, GA 30033 | 2020-09-09 |
| 1700412517 | Delana Finney | Orthotist | Vamc - Atlanta, 1670 Clairmont Rd, Decatur, GA 30033 | 2020-03-13 |
| 1194389353 | Katherine Serafen | Physician Assistant | 2701 N Decatur Road, Ground Floor Suite 520, Decatur, GA 30033 | 2019-04-23 |
| 1194290973 | Suzanne Johnson | Psychologist | Atlanta Va Health Care System, 1670 Clairmont Rd, Decatur, GA 30033 | 2018-10-09 |
| 1245705334 | Mcleod Counseling Services, LLC | Clinic/Center | 2801 N. Decatur Rd, Suite 185, Decatur, GA 30033 | 2018-10-04 |
| 1225514797 | Erkin Mirkhatovich Turganov | Pharmacist | 2951 Cedar Brook Dr, Decatur, GA 30033 | 2018-07-17 |
| 1356834972 | Sharlencia Lord | Nurse Practitioner | 2738 N Decatur Rd # 292-3173, Decatur, GA 30033 | 2018-06-08 |
| 1194213140 | Zacarias Yanis Jr. | Clinical Neuropsychologist | 1276 Mcconnell Drive Ste C., Decatur, GA 30033 | 2018-04-25 |
| 1780181370 | Ryan Patton | Orthopaedic Surgery | 2723 Hollywood Dr, Decatur, GA 30033 | 2018-04-10 |
| 1437669751 | Sholanda D Hooper | Nurse Practitioner | 1601 Clairmont Rd, Decatur, GA 30033 | 2017-10-02 |
| Find all providers in zip 30033 | ||||
| Taxonomy Code | 207ZD0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Dermatopathology |
| A dermatopathologist is an expert in diagnosing and monitoring diseases of the skin including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of light microscopy, electron microscopy, and fluorescence microscopy. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source added] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. A subspecialty certificate was first issued by the ABMS in 1974. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053392191 | Ling Chen | Pathology | 1951 Clairmont Rd, Decatur, GA 30033-3415 | 2005-11-07 |
| 1912900697 | Steve M Covington IIi | Pathology | 2701 N Decatur Rd, Decatur, GA 30033-5918 | 2005-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871630350 | Seth Ian Rosenthal | Pathology | 1901 Phoenix Blvd Ste 210, Atlanta, GA 30349-5062 | 2007-01-31 |
| 1780623785 | Jessie Lee | Pathology | 175 White St Nw, Suite 370, Marietta, GA 30060-1053 | 2006-06-05 |
| 1295798320 | Wayne L Bakotic | Pathology | 114 Mimosa Dr, Suite C, Thomasville, GA 31792-6677 | 2006-04-10 |
| 1134193774 | Drazen M Jukic | Pathology | 5400 Sutlive St, Suite 3, Savannah, GA 31405-4721 | 2006-02-13 |
| 1639158389 | Scott M Acker | Pathology | 6240 Shiloh Rd Ste B, Alpharetta, GA 30005-8347 | 2006-01-11 |
| 1295710754 | Bradley W. Bakotic | Pathology | 2001 Westside Parkway, Suite 290, Alpharetta, GA 30004-8514 | 2005-12-07 |
| 1093797144 | Michael J Palko IIi | Pathology | 510 E Oglethorpe Hwy, Hinesville, GA 31313 | 2005-11-15 |
| 1649270885 | Jordan H. Berne | Pathology | 6095 Barfield Rd Ne, Suite 200, Atlanta, GA 30328-4408 | 2005-07-29 |
| 1588667380 | Christopher J Kligora | Pathology | 311 W 8th St Ne, Rome, GA 30165-2723 | 2005-05-24 |
| 1295386928 | Podpath, Inc | Pathology | 2000 Lake Park Dr Se, Smyrna, GA 30080-7611 | 2019-09-24 |
| 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.