Ken Smith (NPI# 1033101126, PAC ID# 8820203664) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEUROSURGERY.
| Nation Provider ID (NPI) | 1033101126 |
| PAC ID by PECOS | 8820203664 |
| Professional Enrollment ID | I20140214000295 |
| Full Name | Ken Smith |
| Organization Legal Name | BLUE RIDGE NEUROSCIENCE CENTER, P.C. |
| Address |
2 Sheridan Square Suite 200 Kingsport TN 37660-7390 |
| Phone Number | 4232243100 |
| Gender | M |
| Medical School | EMORY UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1983 |
| Primary Specialty | NEUROSURGERY |
| Group Practice PAC ID | 8224090519 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440017 | WELLMONT HOLSTON VALLEY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2 Sheridan Square, Suite 200, Kingsport, TN 37660-7390 | 4232243100 | BLUE RIDGE NEUROSCIENCE CENTER, P.C. |
| Organization Legal Name | BLUE RIDGE NEUROSCIENCE CENTER, P.C. |
| Physicians | 1 |
| Street Address |
2 SHERIDAN SQUARE SUITE 200 |
| City | KINGSPORT |
| State | TN |
| Zip | 37660-7390 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lucinda Miller | Critical Care (intensivists) | Wellmont Medical Associates Inc | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 |
| Daniel D Carroll | Family Medicine | Wellmont Medical Associates Inc | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 |
| Wendy Vogel | Nurse Practitioner | Wellmont Medical Associates Inc | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 |
| Jennifer Leigh Cox | Nurse Practitioner | Wellmont Medical Associates Inc | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 |
| Marsha G Rose | Clinical Social Worker | 2005 Venture Park, Kingsport, TN 37660-1098 | |
| Shelley Hilton | Nurse Practitioner | Dermatology Associates of Kingsport, P.C. | 2300 W Stone Dr, Kingsport, TN 37660-2360 |
| Hannah Ruth Cook | Physician Assistant | Dermatology Associates of Kingsport, P.C. | 2300 W Stone Dr, Kingsport, TN 37660-2360 |
| Carri Beth Homoky | Dermatology | Dermatology Associates of Kingsport, P.C. | 2300 W Stone Dr, Kingsport, TN 37660-2360 |
| Joni Glavan Sago | Dermatology | Dermatology Associates of Kingsport, P.C. | 2300 W Stone Dr, Kingsport, TN 37660-2360 |
| Darrell Ray Millsap | Physician Assistant | Dermatology Associates of Kingsport, P.C. | 2300 W Stone Dr, Kingsport, TN 37660-2360 |
| Find all physicians in zip 37660 | |||
| City | KINGSPORT |
| Zip Code | 37660 |
| Specialty | NEUROSURGERY |
| City + Specialty | KINGSPORT + NEUROSURGERY |
Please comment or provide details below to improve the information on Ken Smith.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.