Active NPI
Gregory Smith
- Student in an Organized Health Care Education/Training Program
- Perrysburg, OH
National Provider Identifier
1023706553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 58.033571
- Practice address
- 7045 Lighthouse Way
Perrysburg, OH 43551-7000 - Phone
- (419) 873-6836
- NPI assigned
- Apr 24, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 58.033571 | OH | Primary |
Addresses
Primary practice location
7045 Lighthouse Way
Perrysburg, OH 43551-7000
Mailing address
707 Bridgeview Dr
Perrysburg, OH 43551-3957
Phone (606) 794-8370
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58.033571 | OH | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725840000000",
"number": "1023706553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 BRIDGEVIEW DR",
"city": "PERRYSBURG",
"state": "OH",
"postal_code": "435513957",
"telephone_number": "606-794-8370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7045 LIGHTHOUSE WAY",
"city": "PERRYSBURG",
"state": "OH",
"postal_code": "435517000",
"telephone_number": "419-873-6836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "GREGORY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-24",
"last_updated": "2024-09-09",
"certification_date": "2024-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "OH",
"license": "58.033571",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Perrysburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.