MR. KENNETH WARREN SMITH SR. (NPI# 1700969649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700969649 |
| Entity Type | Individual |
| Full Name | MR. KENNETH WARREN SMITH SR. |
| Credential | APA-C |
| Practice Address |
1 Jarrett White Rd Tripler Army Medical Center Attn: Mchk-qs Tamc HI 96859-5001 |
| Mailing Address |
8901 Rockville Pike Bethesda MD 20889-0001 |
| Practice Telephone | 8084332460 |
| Practice Fax Number | 8084331558 |
| Mailing Telephone | 3014002846 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2015-10-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| 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 |
1 JARRETT WHITE RD TRIPLER ARMY MEDICAL CENTER ATTN: MCHK-QS |
| City | TAMC |
| State | HI |
| Zip Code | 96859-5001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548268188 | Millard Dalton Brown IIi | Psychiatry & Neurology | 1 Jarrett White Rd, Tamc, HI 96859-5001 | 2005-07-08 |
| 1801092689 | Susanna Naomi Holt | Student in an Organized Health Care Education/Training Program | 1 Jarrett White Rd, Tripler Army Medical Center, Tamc, HI 96859-5001 | 2007-06-27 |
| 1104023712 | Phuoc T Nguyen | General Practice | 1 Jarrett White Rd, Tripler Army Medical Center, Tamc, HI 96859-5001 | 2007-06-27 |
| 1205032075 | David James Peterson | Student in an Organized Health Care Education/Training Program | 1 Jarrett White Rd, Tripler Army Medical Center, Tamc, HI 96859-5001 | 2007-06-26 |
| 1366648685 | Charles Tri Nguyen | Student in an Organized Health Care Education/Training Program | 1 Jarrett White Rd, Tripler Army Medical Center, Tamc, HI 96859-5001 | 2007-06-24 |
| 1194920546 | Valerie Lopes Pires Edmonds | Student in an Organized Health Care Education/Training Program | 1 Jarrett White Rd, Tripler Army Medical Center, Tamc, HI 96859-5001 | 2007-06-17 |
| 1568667970 | Jordanna M Hostler | Internal Medicine | 1 Jarrett White Rd, Tripler Army Medical Center, Tamc, HI 96859-5001 | 2007-06-15 |
| 1336343987 | Eric Michael Swanson | Student in an Organized Health Care Education/Training Program | 1 Jarrett White Rd, Tripler Army Medical Center, Tamc, HI 96859-5001 | 2007-06-14 |
| 1083818595 | Michael Emil Stoudmire | General Practice | 1 Jarrett White Rd, Tripler Army Medical Center, Tamc, HI 96859-5001 | 2007-06-11 |
| 1700080231 | Christina B Rumayor | Student in an Organized Health Care Education/Training Program | 1 Jarrett White Rd, Tripler Army Medical Center, Tamc, HI 96859-5001 | 2007-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770115792 | The Janz Corporation | Durable Medical Equipment & Medical Supplies | Tripler Medical Center, C-103, Honolulu, HI 96859 | 2020-02-07 |
| 1467726927 | Elton E Bacon | Orthotist | 1 Jarrett White Rd Dept of The Army, Attn: Orthopedic Brace Clinic (mchk-dso-a), Tripler Amc, HI 96859 | 2012-03-01 |
| 1063738813 | Defense Finance & Actg Service | Military Hospital | 691 Schofield Barracks, U.s Army Health Clinic Bldg, Wahiawa, HI 96859 | 2010-04-19 |
| 1972737153 | Kyong Su Min | Orthopaedic Surgery | 1 Jarrett White Rd Bldg 4f, Tripler Army Medical Center, HI 96859 | 2009-05-04 |
| 1558503854 | Mark Andrew Gerum | Social Worker | Tripler Army Medical Center, 1 Jarrett White Road, Intensive Outpatient Program (iop), Honolulu, HI 96859 | 2009-04-01 |
| 1578720926 | Travis Jaya Mason | Surgery | Tripler Army Medical Center 1 Jarrett White Road, Honolulu, HI 96859 | 2008-05-21 |
| 1467513168 | Joselyn Cabalo Funtanilla Ponce | Registered Nurse | 1 Jarrett White Rd Bldg 4, Tripler Amc, HI 96859 | 2006-12-13 |
| 1346280195 | Harkirtin Kaur Mciver | Pediatrics | Tripler Army Medical Center Mchk-pe, 1 Jarrett White Road, Honolulu, HI 96859 | 2006-06-08 |
| 1043297740 | Jacqueline Seger | Registered Nurse | Tamc 1 Jarrett-white Rd., 1 Jarrett-white Rd. / Mchk-dsc, Honolulu, HI 96859 | 2005-12-23 |
| 1982694683 | Peter Marlin | Psychiatry & Neurology | Tamc, 1 Jarriet White Road, Honolulu, HI 96859 | 2005-10-24 |
| Find all providers in zip 96859 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174557359 | Nathan Milan Setka | Physician Assistant | 1 Jarrett White Rd, Tripler Army Medical Center, Tamc, HI 96859-5001 | 2006-07-11 |
| 1134191885 | Roy Erickson Wallace | Physician Assistant | 1 Jarrett White Rd, Tamc, Personnel Division, Tamc, HI 96859-5001 | 2006-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205433505 | Jessica Renae Hall | Physician Assistant | 201 Bougainvillea Loop, Honolulu, HI 96818-1495 | 2020-10-08 |
| 1508472085 | Lauren Whitney Hall | Physician Assistant | 91-1368 Kaileolea Dr, Ewa Beach, HI 96706-6289 | 2020-09-19 |
| 1568076685 | Emily Rose Callaway | Physician Assistant | 501 Hahaione St Apt 8j, Honolulu, HI 96825-1444 | 2020-09-04 |
| 1053939124 | Jamie Tamayose | Physician Assistant | 46-1063 Emepela Way Apt 6u, Kaneohe, HI 96744-3940 | 2020-07-06 |
| 1982161782 | Amanda Laurent | Physician Assistant | 1401 S Beretania St Ste 102, Honolulu, HI 96814-1871 | 2019-02-28 |
| 1720578693 | Ashley Marie Mccall | Physician Assistant | 900 Fort Street Mall Ste 1040, Honolulu, HI 96813-3701 | 2018-05-15 |
| 1245720564 | Zi Xiang Liu | Physician Assistant | 3399 Glennan Street, Schofield Barracks, HI 96786 | 2018-05-11 |
| 1902300056 | Hawaii Care Connect Medical Group LLC | Physician Assistant | 94-356 Waipahu Depot St Ste 204, Waipahu, HI 96797-3057 | 2018-03-22 |
| 1154835353 | Arthur Burgos Domingo | Physician Assistant | 445 Seaside Ave, Honolulu, HI 96815-2640 | 2017-11-27 |
| 1982121059 | Salvador Mireles Thorn | Physician Assistant | U.S. Army Health Clinic Sb, Building 683, Schofield Barracks, HI 96786 | 2017-08-29 |
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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.