Individual provider Active NPI

Constance Marie Smith-Krueger, R.N.

  • Registered Nurse
  • Northfield, OH
National Provider Identifier
1528260320
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN.221513 Issued in OH
Practice address
100 Hazel Dr
Northfield, OH 44067-2822
Phone
(330) 474-0619
NPI assigned
Jun 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.221513 OH Primary

Addresses

Primary practice location

100 Hazel Dr
Northfield, OH 44067-2822

Mailing address

100 Hazel Dr
Northfield, OH 44067-2822
Phone (330) 474-0619

Other identifiers 1

IdentifierTypeStateIssuer
RN.221513OtherOHRN LICENSE OHIO

Other names 1

  • Ms. Constance Marie Smith Former name

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.221513OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528260320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HAZEL DR",
            "city": "NORTHFIELD",
            "state": "OH",
            "postal_code": "440672822",
            "telephone_number": "330-474-0619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HAZEL DR",
            "city": "NORTHFIELD",
            "state": "OH",
            "postal_code": "440672822",
            "telephone_number": "330-474-0619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-KRUEGER",
        "first_name": "CONSTANCE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.221513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE OHIO",
            "identifier": "RN.221513",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONSTANCE",
            "last_name": "SMITH",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "R.N.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Northfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.