Jennifer Lee Smith, CNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

COA10628NP Issued in OH

Practice address

4900 Oak Street
Berlin, OH 44610-0426

Phone

(330) 893-1318

Fax

(330) 893-1485

NPI assigned

Mar 12, 2009

Last updated

Mar 31, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jennifer Lee Reynolds Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1023259603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 426",
            "city": "BERLIN",
            "state": "OH",
            "postal_code": "446100426",
            "telephone_number": "330-893-1318",
            "fax_number": "330-893-1485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 OAK STREET",
            "city": "BERLIN",
            "state": "OH",
            "postal_code": "446100426",
            "telephone_number": "330-893-1318",
            "fax_number": "330-893-1485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-12",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA10628NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3003556",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "REYNOLDS",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert L. Miller, OD Inc.
• Carrie Schlabach, FNP-C
• Jill R Sebert-Reese, DDS
• Vanessa Shutt, NP
• Amanda K Sindel, RDH
• Tammi Kim Snow, RN
• Lindsay Nicole Stutzman, D.D.S.
• Maurice W Stutzman, MD
• Michael Allen Stutzman, D.D.S.
• Candy Yoder, APRN

• Adult Health Nurse Practitioner in Berlin, OH
• Providers in Berlin, OH by specialty
• Adult Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.