Kelley Elizabeth Smith, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036142017 Issued in IL

Practice address

1735 27TH St
Waller BLDG. Suite B 06
Portsmouth, OH 45662-2677

Phone

(740) 356-8051

NPI assigned

Jul 31, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, IL2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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 and National Provider Directory roles.

• Epmg of Ohio Inc P a

  • Emergency Medicine Physician
  • Portsmouth, OH
  • NPI 1841232196

  Single Specialty

  Medicare reassignment NPD
• Advocate Health and Hospitals Corporation

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455

  Single Specialty

  Medicare reassignment NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Elgin, IL
  • NPI 1912283110

  Single Specialty

  Medicare reassignment NPD
• Epss LLC - Central Series

  • Emergency Medicine Physician
  • Pekin, IL
  • NPI 1538680467

  Single Specialty

  Medicare reassignment NPD
• Epss Peoria LLC

  • Emergency Medicine Physician
  • Peoria, IL
  • NPI 1831421056

  Single Specialty

  Medicare reassignment NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527

  Single Specialty

  Medicare reassignment NPD
• Saint James Hospital

  • Anesthesiology Physician
  • Pontiac, IL
  • NPI 1790735421

  Single Specialty

  Medicare reassignment NPD
• St Joseph Medical Center

  • Family Medicine Physician
  • Bloomington, IL
  • NPI 1871547414

  Single Specialty

  Medicare reassignment NPD
• Advocate Health & Hospitals Corporation

  • Medical Specialty Clinic/Center
  • Oak Lawn, IL
  • NPI 1912936014

  Single Specialty

  NPD
• Advocate Health and Hospitals Corporation

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD
• Bloomington Medical Laboratory Physicians, S.C.

  • Anatomic Pathology & Clinical Pathology Physician
  • Bloomington, IL
  • NPI 1841229507

  Single Specialty

  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413

  Single Specialty

  NPD

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1366874471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 27TH ST",
            "address_2": "WALLER BLDG. SUITE B 06",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622677",
            "telephone_number": "740-356-8051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 27TH ST",
            "address_2": "WALLER BLDG. SUITE B 06",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622677",
            "telephone_number": "740-356-8051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELLEY",
        "middle_name": "ELIZABETH",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036142017",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "58004885",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clara Smith, CRNA
• Cory Smith
• Jarod Smith
• Jason Smith
• Justin Smith
• Kristin Smith
• Lacie Jo Smith, APRN-CNP
• Lisa A. Smith, CRNA,DMPNA,APRN
• Mary Danielle Smith, LICDC, QMHS
• Michael Thomas Smith, ACNP

• Emergency Medicine Physician in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.