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KELLY A SMITH IDC
NPI 1689830788
Military Health Care Provider - Independent Duty Corpsman in Gulfport, MS

Active since July 29, 2008
5501 MARVIN SHIELDS BLVD, GULFPORT, MS 39501(228) 871-2810 Get Directions Write a Review

NPPES record last updated: July 29, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kelly A Smith Idc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY A SMITH IDC (NPI 1689830788) is an individual independent duty corpsman provider in Gulfport, Mississippi and active in the NPI registry since July 2008.

NPPES Registry Identity

NPI1689830788
Entity TypeIndividualFemale
Primary Taxonomy1710I1002X
Provider Legal NameKELLY A SMITHCredential: IDC
Location Address5501 MARVIN SHIELDS BLVDGulfport, MS 39501-9007
Mailing Address3150 Holloway DrGulfport, MS 39501-9030 · (228) 871-2810
Phone(228) 871-2810
Sole ProprietorYes
Enumeration DateJuly 29, 2008
✔ NPI 1689830788 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers
Taxonomy Code1710I1002X
Definition
A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
5501 MARVIN SHIELDS BLVD, Gulfport, MS 39501
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Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. DAVID RAY BRANCH IDC
Specialist/Technologist, Other
5501 MARVIN SHIELDS BLVD
GULFPORT, MS 39501
Harrison County (228) 871-2810
JESSE LEE PALACIOS II
Military Health Care Provider (Independent Duty Corpsman)
5501 MARVIN SHIELDS BLVD
GULFPORT, MS 39501
Harrison County (228) 871-2810
DAVID CHARLES HALBERG
Military Health Care Provider (Independent Duty Corpsman)
5501 MARVIN SHIELDS BLVD
GULFPORT, MS 39501
Harrison County (228) 871-2810
MR. DAVID ALEXANDER GLENN JR. IDC
Military Health Care Provider (Independent Duty Corpsman)
5501 MARVIN SHIELDS BLVD
GULFPORT, MS 39501
Harrison County (228) 822-5061
DR. STEPHEN L MIKELL MD
Pediatrics
5501 MARVIN SHIELDS BLVD
GULFPORT, MS 39501
Harrison County (228) 871-4033
COLTON ANTHONY WEGRZYN IDC
Military Health Care Provider (Independent Duty Corpsman)
5501 MARVIN SHIELDS BLVD
GULFPORT, MS 39501
Harrison County (228) 822-5919
MR. CHARLES EDWARD GIVENS JR. IDC
Military Health Care Provider (Independent Duty Corpsman)
5501 MARVIN SHIELDS BLVD
GULFPORT, MS 39501
Harrison County (228) 871-2810
MS. JULIE BISHOP LCSW
Social Worker (Clinical)
5501 MARVIN SHIELDS BLVD
GULFPORT, MS 39501
Harrison County (228) 822-5067

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Smith's NPI number?

The NPI number for Kelly Smith is 1689830788. It was assigned to this individual provider in the NPPES registry on July 29, 2008.

Where is Kelly Smith located?

Kelly Smith practices at 5501 Marvin Shields Blvd, Gulfport, MS 39501. The listed phone number is (228) 871-2810.

What is Kelly Smith's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Kelly Smith was last updated on July 29, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.