Individual provider Active NPI

Diane K Smith, LPT

  • Counselor
  • Chillicothe, OH
National Provider Identifier
1568400422
Registry record updated Nov 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
111 W Water St
Chillicothe, OH 45601-2452
Phone
(740) 851-4432
Fax
(740) 851-4712
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6591 OH
Counselor 101Y00000X Primary

Addresses

Primary practice location

111 W Water St
Chillicothe, OH 45601-2452

Mailing address

111 W Water St
Chillicothe, OH 45601-2452
Phone (740) 851-4432

Other practice location 1

17273 State Route 104
Chillicothe, OH 45601-8608
Phone (740) 773-1141 ext. 7646

Other identifiers 1

IdentifierTypeStateIssuer
1568400422MedicaidOH

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
6591OHMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1568400422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W WATER ST",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456012452",
            "telephone_number": "740-851-4432",
            "fax_number": "740-851-4712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W WATER ST",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456012452",
            "telephone_number": "740-851-4432",
            "fax_number": "740-851-4712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17273 State Route 104",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "OH",
            "postal_code": "456018608",
            "country_code": "US",
            "telephone_number": "740-773-1141 x7646",
            "fax_number": "740-772-7144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DIANE",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "LPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "6591",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568400422",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chillicothe, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; 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.