Individual provider Active NPI

Dionne Vanessa Smith, M.D.

  • Pediatrics Physician
  • Champaign, IL
National Provider Identifier
1558628396
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036138395 Issued in IL
Practice address
1701 W. Curtis Rd.
Champaign, IL 61822-9678
Phone
(217) 365-6202
Fax
(217) 326-0188
NPI assigned
Apr 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036138395 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1701 W. Curtis Rd.
Champaign, IL 61822-9678

Mailing address

303 G H Baker Dr
Urbana, IL 61801-1160
Phone (217) 326-6202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 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

Enrollment IDStateProvider typePAC IDDetails
I20150804003570 IL Practitioner - Pediatric Medicine 7315251444 Reassigns benefits to 1 organization
I20251114000133 MO Practitioner - Pediatric Medicine 7315251444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Medical College of Wisconsin, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12800 Corporate Hill Dr
Saint Louis, MO 63131-1833

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Cardinal Glennon Childrens Hospital Pediatrics CurrentSince Sep 8, 2025 Accepting new patients
SSM Cardinal Glennon Children'S Hospital Pediatrics CurrentSince Sep 8, 2025 Accepting new patients
Carle Health Care Incorporated CurrentSince Jul 21, 2015 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1701 Curtis Rd
Champaign, IL 61822
Phone (217) 365-6201

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

13000 Butler Crest Dr
Saint Louis, MO 63128
Phone (314) 842-3535

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

Interoperability endpoints

  • Direct secure messaging: dsmith541933@direct-ehr-ssmhc.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1558628396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 G H BAKER DR",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618011160",
            "telephone_number": "217-326-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W. CURTIS RD.",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618229678",
            "telephone_number": "217-365-6202",
            "fax_number": "217-326-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DIONNE",
        "middle_name": "VANESSA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-18",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036138395",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.