Individual provider Active NPI

Robert T Smith, MD

  • Internal Medicine Physician
  • Miamisburg, OH
National Provider Identifier
1225019391
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35048661 Issued in OH
Practice address
2115 Leiter Rd
Miamisburg, OH 45342-3659
Phone
(937) 384-6800
Fax
(937) 384-6939
NPI assigned
Nov 7, 2005
Last updated
Nov 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35048661 OH Primary

Addresses

Primary practice location

2115 Leiter Rd
Miamisburg, OH 45342-3659

Mailing address

2115 Leiter Rd
Miamisburg, OH 45342-3659
Phone (937) 384-6800

Other identifiers 1

IdentifierTypeStateIssuer
0554412MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rsmith200591@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

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
I20100407000424 OH Practitioner - Internal Medicine 6901702596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.8 of 100Reported as group
Quality
73.21
Promoting interoperability
100
Improvement activities
40
Cost
76.12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35048661OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physicians Inc Internal Medicine CurrentSince Jan 16, 2010 Accepting new patients
Alliance Physicians Inc CurrentSince Jan 16, 2010 Accepting new patients

Locations

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

2115 Leiter Rd
Miamisburg, OH 45342
Phone (937) 384-6920

2115 Leiter Rd
Ste 300
Miamisburg, OH 45342

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kettering Health Primary Care, a Service of Kettering Health Greene MeYellow Springs, OH, CCN 363401 Rural health clinic Corporate Director May 1, 2022
Kettering Health Primary Care, a Service of Kettering Health Greene MeCedarville, OH, CCN 363400 Rural health clinic Corporate Director May 1, 2022
Kettering Health Primary Care, a Service of Soin Medical CenterWilmington, OH, CCN 363438 Rural health clinic Corporate Director May 1, 2022

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1225019391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 LEITER RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423659",
            "telephone_number": "937-384-6800",
            "fax_number": "937-384-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 LEITER RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423659",
            "telephone_number": "937-384-6800",
            "fax_number": "937-384-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROBERT",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35048661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0554412",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rsmith200591@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "2115 Leiter Rd",
            "city": "Miamisburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453423659",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2115 Leiter Rd",
            "city": "Miamisburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453423659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miamisburg, OH

Sources for this page

Verify at the official NPI Registry.