Individual provider Active NPI

Audrey Ann Smith, CRNP

  • Adult Health Nurse Practitioner
  • Youngstown, OH
National Provider Identifier
1184615254
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NP06525 Issued in OH
Practice address
216 Terra Bella Dr
Youngstown, OH 44505-1045
Phone
(330) 506-7514
Fax
(234) 254-8026
NPI assigned
Oct 28, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NP06525 OH Primary

Addresses

Primary practice location

216 Terra Bella Dr
Youngstown, OH 44505-1045

Mailing address

PO Box 5254
Poland, OH 44514-0254
Phone (330) 506-7514

Other identifiers 1

IdentifierTypeStateIssuer
2284960MedicaidOH

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
I20040325000465 OH Practitioner - Nurse Practitioner 9739071911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

216 Terra Bella Dr
Youngstown, OH 44505-1045
Phone (330) 506-7514

Hospital & facility affiliations

  • Akeso Home Health Care Inc Home health agency, Canfield, OH, CCN 368475
  • Windsor Home Health Home health agency, Girard, OH, CCN 368278
  • Akeso Home Hospice Inc Hospice, Canfield, OH, CCN 361707
  • East Liverpool City Hospital Hospital, East Liverpool, OH, CCN 360096

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP06525OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NP Health Services LLC CurrentSince Jan 25, 2012 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DDIBDD/Endpoint/DDIBDD

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.

Hospital & facility affiliations 4

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": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1184615254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5254",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445140254",
            "telephone_number": "330-506-7514",
            "fax_number": "234-254-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 TERRA BELLA DR",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051045",
            "telephone_number": "330-506-7514",
            "fax_number": "234-254-8026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AUDREY",
        "middle_name": "ANN",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-28",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "NP06525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2284960",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.