Phyllis Jean Smith

Primary specialty

Home Health AideTaxonomy code 374U00000X

Practice address

15162 Mohler Rd
Logan, OH 43138

Phone

(740) 767-9874

NPI assigned

Feb 1, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164560389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23600 ST RT 13",
            "city": "GLOUSTER",
            "state": "OH",
            "postal_code": "457329728",
            "telephone_number": "740-767-9874",
            "fax_number": "740-767-9874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15162 MOHLER RD",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "43138",
            "telephone_number": "740-767-9874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PHYLLIS",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WAIVER",
            "identifier": "2294306",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ariana Marie Smith
• Ashlee Anne Smith
• Holly Christine Smith, APRN-CNP
• John P Smith Jr., DDS
• Lauren Smith, QMHS
• Darren J Sommer, D.O
• Katherine Soucie
• South Central Ohio Anesthesia LLC
• Southeastern Ohio Home Health & Staffing Solutions Inc
• Southeastern Surgery

• Home Health Aide in Logan, OH
• Providers in Logan, OH by specialty
• Home Health Aide in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.