Individual provider Active NPI

Michael Smith, M.D.

  • Hospitalist Physician
  • Dayton, OH
National Provider Identifier
1104169697
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
35.128066 Issued in OH
Practice address
1222 S Patterson Blvd
Ste 220
Dayton, OH 45402-2684
Phone
(937) 223-5350
Fax
(937) 224-3112
NPI assigned
Apr 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.128066 OH
Hospitalist Physician 208M00000X 35.128066 OH Primary

Addresses

Primary practice location

1222 S Patterson Blvd
Ste 220
Dayton, OH 45402-2684

Mailing address

725 University Blvd
Dayton, OH 45435-0001
Phone (937) 245-7100

Other practice location 1

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-6665

Other identifiers 1

IdentifierTypeStateIssuer
0167298MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address msmith532010@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160802000624 OH Practitioner - HospitalistPractitioner - Internal Medicine 5597993949 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc Internal Medicine CurrentSince Dec 29, 2022 Accepting new patients

Locations

3535 Pentagon Blvd
Beavercreek, OH 45431
Phone (937) 702-4000

405 W Grand Ave
Fl 4
Dayton, OH 45405
Phone (937) 558-3500

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342
Phone (937) 384-8791

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

1141 N Monroe Dr
Xenia, OH 45385
Phone (937) 352-2000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1104169697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 UNIVERSITY BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454350001",
            "telephone_number": "937-245-7100",
            "fax_number": "937-245-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S PATTERSON BLVD",
            "address_2": "STE 220",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022684",
            "telephone_number": "937-223-5350",
            "fax_number": "937-224-3112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291221",
            "country_code": "US",
            "telephone_number": "937-395-6665",
            "fax_number": "937-395-6668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.128066",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35.128066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0167298",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msmith532010@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3535 Southern Blvd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3535 Southern Blvd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.