Kip L Smith, PH.D

Primary specialty

Rehabilitation PsychologistTaxonomy code 103TR0400X

License

P.5006 Issued in OH

Practice address

480 Medical Center Dr
Columbus, OH 43210-1229

Phone

(614) 293-7604

Fax

(614) 293-3809

NPI assigned

Aug 11, 2006

Reactivated

Apr 8, 2025

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

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Ohio State University College of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Osu Physical Medicine and Rehabilitation LLCGroup PAC ID 7012960644, 35 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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

• Osu Physical Medicine and Rehabilitation, LLC

  • Physical Medicine & Rehabilitation Physician
  • Columbus, OH
  • NPI 1003029455
  Medicare reassignment Care Compare group NPD
• Kip Smith, PHD Rehabilitation Psychology LLC

  • Rehabilitation Psychologist
  • Beachwood, OH
  • NPI 1316748742
  NPD Authorized official
• Neuropsychology and Psychotherapy Services of Cleveland LLC

  • Clinical Neuropsychologist
  • Beachwood, OH
  • NPI 1073575106
  NPD

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1205847449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-7604",
            "fax_number": "614-293-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 MEDICAL CENTER DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101229",
            "telephone_number": "614-293-7604",
            "fax_number": "614-293-3809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 Green Rd Ste 218",
            "address_purpose": "LOCATION",
            "city": "Beachwood",
            "state": "OH",
            "postal_code": "441225719",
            "country_code": "US",
            "telephone_number": "216-407-3470",
            "fax_number": "216-595-0088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIP",
        "middle_name": "L",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "deactivation_date": "2025-03-21",
        "reactivation_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "OH",
            "license": "P.5006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendra Lynn Smith
• Kenneth Smith, MA, LPCC
• Keonna Smith
• Kerri Lynne Smith, COTA/L
• Kimberly Smith
• Kitwan Smith
• Krishawn Smith
• Kristina S Smith
• Kyle Smith, DPT, PT, OCS
• Kyle Smith, PA

• Rehabilitation Psychologist in Columbus, OH
• Providers in Columbus, OH by specialty
• Rehabilitation Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.