Individual provider Active NPI

Nicholas Demico Smith

  • Intellectual & Developmental Disabilities Psychologist
  • Cincinnati, OH
National Provider Identifier
1588377683
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
Practice address
800 Fairborn Rd
Cincinnati, OH 45240-2502
Phone
(513) 827-7190
NPI assigned
Jan 4, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities Psychologist 103TM1800X Primary

Addresses

Primary practice location

800 Fairborn Rd
Cincinnati, OH 45240-2502

Mailing address

800 Fairborn Rd
Cincinnati, OH 45240-2502
Phone (513) 827-7190

Other identifiers 1

IdentifierTypeStateIssuer
5628MedicaidOH

Electronic endpoints 10

TypeEndpointUseAffiliation
Direct Messaging Address mrnsmith1@outlook.com Direct
Direct Messaging Address mrnsmith1@outlook.com Direct
Direct Messaging Address mrnsmith1@outlook.com Direct
Direct Messaging Address mrnsmith1@outlook.com Direct
Direct Messaging Address mrnsmith1@outlook.com Direct
Direct Messaging Address mrnsmith1@outlook.com Direct
Direct Messaging Address mrnsmith1@outlook.com Direct
Direct Messaging Address mrnsmith1A@outlook.com Direct
Direct Messaging Address mrnsmith1@outlook.com Direct
Direct Messaging Address mrnsmith1@outlook.com Direct

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

NPI Registry JSON

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1588377683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FAIRBORN RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452402502",
            "telephone_number": "513-827-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 FAIRBORN RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452402502",
            "telephone_number": "513-827-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICHOLAS",
        "middle_name": "DEMICO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-04",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5628",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrnsmith1@outlook.com",
            "affiliation": "N",
            "endpointDescription": "mrnsmith1@outlook.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Fairborn Rd",
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        },
        {
            "endpointType": "DIRECT",
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            "endpoint": "mrnsmith1@outlook.com",
            "affiliation": "N",
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            "use": "DIRECT",
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            "address_1": "800 Fairborn Rd",
            "city": "Cincinnati",
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            "address_type": "DOM"
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        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrnsmith1@outlook.com",
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        {
            "endpointType": "DIRECT",
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            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
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            "endpoint": "mrnsmith1@outlook.com",
            "affiliation": "N",
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            "use": "DIRECT",
            "useDescription": "Direct",
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            "contentTypeDescription": "CSV",
            "address_1": "800 Fairborn Rd",
            "city": "Cincinnati",
            "state": "OH",
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            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrnsmith1@outlook.com",
            "affiliation": "N",
            "endpointDescription": "mrnsmith1@outlook.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Fairborn Rd",
            "city": "Cincinnati",
            "state": "OH",
            "country_code": "US",
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            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrnsmith1@outlook.com",
            "affiliation": "N",
            "endpointDescription": "mrnsmith1@outlook.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Fairborn Rd",
            "city": "Cincinnati",
            "state": "OH",
            "country_code": "US",
            "postal_code": "452402502",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrnsmith1A@outlook.com",
            "affiliation": "N",
            "endpointDescription": "mrnsmith1@outlook.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Fairborn Rd",
            "city": "Cincinnati",
            "state": "OH",
            "country_code": "US",
            "postal_code": "452402502",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrnsmith1@outlook.com",
            "affiliation": "N",
            "endpointDescription": "mrnsmith1@outlook.com",
            "use": "DIRECT",
            "useDescription": "Direct",
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            "contentTypeDescription": "CSV",
            "address_1": "800 Fairborn Rd",
            "city": "Cincinnati",
            "state": "OH",
            "country_code": "US",
            "postal_code": "452402502",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrnsmith1@outlook.com",
            "affiliation": "N",
            "endpointDescription": "mrnsmith1@outlook.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Fairborn Rd",
            "city": "Cincinnati",
            "state": "OH",
            "country_code": "US",
            "postal_code": "452402502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jan 4, 2023; 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.