Individual provider Active NPI

Neesha Smith, CNP

  • Nurse Practitioner
  • Jackson, OH
National Provider Identifier
1063432771
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
161878 Issued in OH
Practice address
280 Pattonsville Rd
Jackson, OH 45640-9452
Phone
(740) 395-8805
Fax
(740) 395-8855
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 161878 OH Primary

Addresses

Primary practice location

280 Pattonsville Rd
Jackson, OH 45640-9452

Mailing address

90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 395-8805

Other identifiers 5

IdentifierTypeStateIssuer
000000312590OtherANTHEM BCBS
7105059000MedicaidWV
500016983OtherRR MEDICARE
2245252MedicaidOH
000000185174OtherOHOH MEDICAID UNISON

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address neesha.smith.1@17389.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

90 Jackson Pike
Gallipolis, OH 45631-1560

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.27 of 100Reported as group
Quality
68.56
Promoting interoperability
100
Improvement activities
40
Cost
68.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
161878OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Holzer Hospital Foundation Past Accepting new patients
Holzer Medical Center Jackson Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1063432771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-395-8805",
            "fax_number": "740-395-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 PATTONSVILLE RD",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456409452",
            "telephone_number": "740-395-8805",
            "fax_number": "740-395-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NEESHA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "161878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000312590",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7105059000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "500016983",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2245252",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OH MEDICAID UNISON",
            "identifier": "000000185174",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "neesha.smith.1@17389.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "280 Pattonsville Rd",
            "city": "Jackson",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456409452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, OH

Sources for this page

Verify at the official NPI Registry.