NPIMap

Individual provider Active NPI

Alexis Marie Smith, D.O.

  • Diagnostic Radiology Physician
  • Youngstown, OH
National Provider Identifier
1417128380
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
34.011434 Issued in OH
Practice address
7177 Struthers Rd
Youngstown, OH 44514-2270
Phone
(215) 869-2134
NPI assigned
Mar 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X OS016619 PA
Diagnostic Radiology Physician 2085R0202X 34.011434 OH Primary

Addresses

Primary practice location

7177 Struthers Rd
Youngstown, OH 44514-2270

Mailing address

1420 Centre Ave Apt 1910
Pittsburgh, PA 15219-3527
Phone (215) 869-2134

Other names 1

  • Dr. Alexis Smith Shively Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131115000307 PA Practitioner - Diagnostic Radiology 0749416071 Reassigns benefits to 1 organization
I20140805003099 OH Practitioner - Diagnostic Radiology 0749416071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Philadelphia College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dubois Regional Medical CenterGroup PAC ID 5890689715, 424 clinicians

Practice addresses (Care Compare)

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-3261

1225 Warm Springs Ave
Huntingdon, PA 16652-2350
Phone (814) 643-8623

187 Hospital Dr
Tyrone, PA 16686-1808
Phone (814) 684-1255

239 Colonnade Blvd
State College, PA 16803-2668
Phone (814) 375-3261

763 Johnsonburg Rd
Saint Marys, PA 15857-3417
Phone (814) 788-8000

809 Turnpike Ave
Clearfield, PA 16830-1232
Phone (814) 765-5341

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.011434OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dubois Regional Medical Center CurrentSince Jun 15, 2024 Accepting new patients
Dubois Regional Medical Center Diagnostic Radiology CurrentSince Jun 15, 2024 Accepting new patients
Columbus Radiology Corp Diagnostic Radiology CurrentSince Sep 1, 2020 Accepting new patients

Locations

107 Royal Birkdale Dr
Ste A
Columbiana, OH 44408
Phone (330) 482-9350

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

111 S Grant Ave
Columbus, OH 43215
Phone (614) 461-3232

100 Medical Center Dr
Springfield, OH 45504
Phone (937) 523-1000

1932 Niles Cortland Rd NE
Ste X
Warren, OH 44484
Phone (330) 306-5371

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

1163 Country Club Rd
Monongahela, PA 15063
Phone (724) 258-1000

Organizations & group practices 3

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.

Hospital & facility affiliations 68

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 68

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1417128380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 CENTRE AVE APT 1910",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152193527",
            "telephone_number": "215-869-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7177 STRUTHERS RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445142270",
            "telephone_number": "215-869-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ALEXIS",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "OS016619",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "34.011434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "SHIVELY",
            "middle_name": "SMITH",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.