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Active NPI 1376945261 Individual Practitioner Male Practitioner

Dr. Kenneth Smith , DNP

Nurse Practitioner - Primary Care • Beale Afb, CA

Professional Overview & Biography Verified Profile Summary

Dr. Kenneth Smith, DNP is a registered healthcare professional specializing in Nurse Practitioner - Primary Care in Beale Afb, CA. Practice services are available at 15301 WARREN SHINGLE RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

15301 Warren Shingle Rd

Beale Afb, CA 959031905

Telephone 5306344623
Associated Practice Facility / Clinic
🏢 9th Medgrp-Beale Facility NPI 1184695991

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Primary Care in Beale Afb, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 8.3 Yrs
Regional Practice Density
2 Specialists

Practicing in Beale Afb, CA (1139 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-12-11
Nurse Practitioner - Primary Care Primary Specialty

NUCC Taxonomy Code: 363LP2300X

State License NM 63613

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
James Feldhausen , IDMT

Military Health Care Provider - Independent Duty Medical Technicians

NPI 1538302823

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

17 Historical Events
📍
Updated Business Mailing Address December 11, 2025

Registered at 15301 WARREN SHINGLE RD BLDG 5700, BEALE AFB, CA 959031905 (Tel: 5306344114)

📍
Updated Practice Location July 17, 2025

Registered at 15301 WARREN SHINGLE RD, BEALE AFB, CA 959031905 (Tel: 5306344623)

📍
Updated Business Mailing Address July 17, 2025

Registered at 15301 WARREN SHINGLE RD, BEALE AFB, CA 959031905 (Tel: 5306344623)

📍
Updated Practice Location January 09, 2025

Registered at UNIT 6180 BOX 245, APO, AE 096046180 (Tel: 3146325000)

📍
Updated Business Mailing Address January 09, 2025

Registered at UNIT 6180 BOX 245, APO, AE 096046180

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 09, 2025

Nurse Practitioner (License #63613 in NM)

📍
Updated Practice Location December 14, 2018

Registered at 224 W D. L. INGRAM AVE, CANNON AFB, NM 881035103 (Tel: 5757841104)

📍
Updated Business Mailing Address December 14, 2018

Registered at 224 W D.L. INGRAM AVE, CANNON AFB, NM 881035103 (Tel: 5757841104)

📍
Updated Practice Location April 25, 2018

Registered at 208 D L INGRAM AVE W, CANNON AFB, NM 881035103 (Tel: 5757841103)

👤
Provider Name / Credentials Updated April 25, 2018

Recorded as KENNETH SMITH, DNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 25, 2018

Nurse Practitioner (License #APRN66962-NP-C in WV)

NPI Profile Active September 23, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location September 23, 2014

Registered at 4301 JONES BRIDGE RD, BETHESDA, MD 208144712 (Tel: 3012959651)

📍
Updated Business Mailing Address September 23, 2014

Registered at 110 PASTURE SIDE WAY, ROCKVILLE, MD 208505913 (Tel: 7243121354)

👤
Provider Name / Credentials Updated September 23, 2014

Recorded as KENNETH SMITH, RN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 23, 2014

Student in an Organized Health Care Education/Training Program (License #66962 in WV)

🟢
Initial NPI Registration & Enumeration September 23, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1376945261
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 23, 2014
Last Update: December 11, 2025
Sole Proprietor: No

Mailing Address

15301 Warren Shingle Rd Bldg 5700

Beale Afb, CA 959031905

Phone: 5306344114

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.