John Joseph Smith

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

101YA0400X Issued in OH

Practice address

17400 Northwood Ave
Lakewood, OH 44107-2210

Phone

(216) 403-8640

Fax

(216) 862-1243

NPI assigned

Feb 6, 2015

Sex

Male

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

State licenses

Practice roles

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.

• Old School LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Lakewood, OH
  • NPI 1215329909
  NPD (past) Authorized official

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

{
    "created_epoch": "1423180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1235520602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 WOOSTER RD",
            "address_2": "SUITE 54",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441162674",
            "telephone_number": "216-407-0437",
            "fax_number": "216-862-5143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17400 NORTHWOOD AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441072210",
            "telephone_number": "216-403-8640",
            "fax_number": "216-862-1243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-06",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "101YA0400X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1714764",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Keith Smith, DDS MD
• Courtney Smith
• Deawna Smith
• Devon Smith, MD
• George Smith, LISW
• Kendall Smith, QMHS
• Matthew J Smith, D.D.S.
• Melissa Smith, M.S. CCC-SLP
• Nikita S Smith, RN
• Rhonda C Smith

• Addiction (Substance Use Disorder) Counselor in Lakewood, OH
• Providers in Lakewood, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; 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.