Mary Grace Smiley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.009034RX Issued in OH

Practice address

100 Jackson Pike
Gallipolis, OH 45631-1560

Phone

(855) 446-5937

NPI assigned

Jan 11, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WV, OH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holzer Clinic LLCGroup PAC ID 5890606008, 266 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holzer Medical Center Hospital, Gallipolis, OH, CCN 360054

Medicare enrollment (NPD)

Enrolled

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.

• Holzer Clinic, LLC

  • Multi-Specialty Clinic/Center
  • Gallipolis, OH
  • NPI 1508817248
  Medicare reassignment Care Compare group
• Valley Health Systems, Inc.

  dba Valley Health Point Pleasant

  • Federally Qualified Health Center (FQHC)
  • Point Pleasant, WV
  • NPI 1912693458
  Medicare reassignment NPD
• I Path LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Gallipolis, OH
  • NPI 1942525563
  NPD
• Valley Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Huntington, WV
  • NPI 1508720913
  NPD

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

• Holzer Hospital Foundation

  • Rural Acute Care Hospital
  • Gallipolis, OH
  • NPI 1942256888
  Care Compare affiliation

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1427709542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1680",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257171680",
            "telephone_number": "304-781-5159",
            "fax_number": "304-523-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "855-446-5937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1542 Spring Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257049501",
            "country_code": "US",
            "telephone_number": "304-696-6035",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2501 Jackson Ave",
            "address_purpose": "LOCATION",
            "city": "Point Pleasant",
            "state": "WV",
            "postal_code": "255502035",
            "country_code": "US",
            "telephone_number": "304-857-0004",
            "fax_number": "304-857-0005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMILEY",
        "first_name": "MARY",
        "middle_name": "GRACE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-11",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.009034RX",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "2756",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Lee Sizemore, PHARMD
• Angelia Dawn Slack, CRNA
• Lisa M Slentz, CRIS RES SPEC
• Trevor Slone, PHARMD
• Tammy Smathers, CNP
• Matthew Smiley
• Smith Family Healthcare, LLP
• Smith Family Healthcare, LLP
• Smith Family Healthcare, LLP (Smith Family Healthcare)
• Smith Wellness Center, LLP

• Physician Assistant in Gallipolis, OH
• Providers in Gallipolis, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.