Individual provider Active NPI

Robert E Smith, M.D.

  • Pulmonary Disease Physician
  • Kettering, OH
National Provider Identifier
1205924859
Registry record updated Jan 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
35-05-0481 Issued in OH
Practice address
3080 Ackerman Blvd
Ste 100
Kettering, OH 45429-3555
Phone
(937) 396-1605
Fax
(937) 396-1607
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 35-05-0481 OH Primary

Addresses

Primary practice location

3080 Ackerman Blvd
Ste 100
Kettering, OH 45429-3555

Mailing address

3080 Ackerman Blvd
Ste 100
Kettering, OH 45429-3555
Phone (937) 396-1605

Other identifiers 1

IdentifierTypeStateIssuer
0552245MedicaidOH

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
I20130429000586 OH Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 5991745812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
University of Michigan Medical School, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dayton Chest Medicine IncGroup PAC ID 4183664105, 2 clinicians

Practice addresses (Care Compare)

3080 Ackerman Blvd
Kettering, OH 45429-3562
Phone (937) 961-1605

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Chest Medicine Inc CurrentSince Oct 20, 1994 Accepting new patients

Locations

130 Martz St
Ste 5
Greenville, OH 45331
Phone (937) 396-1605

3080 Ackerman Blvd
Ste 100
Kettering, OH 45429
Phone (937) 396-1605

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233273600000",
    "number": "1205924859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3080 ACKERMAN BLVD",
            "address_2": "STE 100",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454293555",
            "telephone_number": "937-396-1605",
            "fax_number": "937-396-1607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 ACKERMAN BLVD",
            "address_2": "STE 100",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454293555",
            "telephone_number": "937-396-1605",
            "fax_number": "937-396-1607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROBERT",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2009-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": "35-05-0481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0552245",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.