Individual provider Active NPI

Stacey Michelle Smetzer, CNP

  • Family Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1124333083
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA.11641-NP Issued in OH
Practice address
700 Children'S Drive
Columbus, OH 43205-2696
Phone
(614) 722-2350
Fax
(614) 722-2350
NPI assigned
Aug 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.334240-COA1 OH
Family Nurse Practitioner 363LF0000X COA.11641-NP OH Primary

Addresses

Primary practice location

700 Children'S Drive
Columbus, OH 43205-2696

Mailing address

700 Children'S Drive
Columbus, OH 43205-2696
Phone (614) 722-2350

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101220000295 OH Practitioner - Nurse Practitioner 2062600968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio State University College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Children'S Radiological Institute, IncGroup PAC ID 8921068149, 36 clinicians

Practice addresses (Care Compare)

700 Children'S Dr
Columbus, OH 43205-2664
Phone (614) 722-2350

700 Childrens Dr
Columbus, OH 43205-2664

Hospital & facility affiliations

  • Nationwide Children'S Hospital Hospital, Columbus, OH, CCN 363305

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.334240-COA1OHMDRegistered Nurse
COA.11641-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Radiological Institute, Inc Family CurrentSince May 30, 2013 Accepting new patients
Nationwide Children'S Hospital Past Accepting new patients
Ohio Gastroenterology Group, Inc. Past Accepting new patients

Locations

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

Organizations & group practices 3

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 1

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": "1281916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1124333083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDREN'S DRIVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052696",
            "telephone_number": "614-722-2350",
            "fax_number": "614-722-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDREN'S DRIVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052696",
            "telephone_number": "614-722-2350",
            "fax_number": "614-722-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMETZER",
        "first_name": "STACEY",
        "middle_name": "MICHELLE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-16",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.334240-COA1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.11641-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.