Individual provider Active NPI

Katherine Jeansmithsmith-Madyu Smith-Madyunl, LPN

  • Licensed Practical Nurse
  • Cincinnati, OH
National Provider Identifier
1487828604
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN 125811 IV Issued in OH
Practice address
872 Holyoke Dr
Cincinnati, OH 45240-1839
Phone
(513) 582-6894
NPI assigned
Apr 18, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN 125811 IV OH Primary

Addresses

Primary practice location

872 Holyoke Dr
Cincinnati, OH 45240-1839

Mailing address

872 Holyoke Dr
Cincinnati, OH 45240-1839
Phone (513) 582-6894

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN 125811 IVOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208476800000",
    "number": "1487828604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "872 HOLYOKE DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452401839",
            "telephone_number": "513-582-6894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 HOLYOKE DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452401839",
            "telephone_number": "513-582-6894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-MADYUNL",
        "first_name": "KATHERINE",
        "middle_name": "JEANSMITHSMITH-MADYU",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN 125811 IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; 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.