Individual provider Active NPI

Vicki Jo Smith, REGISTERED NURSE

  • Home Health Registered Nurse
  • Sheffield Lake, OH
National Provider Identifier
1609109347
Registry record updated Sep 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
RN197890 Issued in OH
Practice address
5115 E Lake Rd
Apt 206
Sheffield Lake, OH 44054-1751
Phone
(440) 785-8570
NPI assigned
Sep 14, 2009
Last updated
Sep 14, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X RN197890 OH Primary

Addresses

Primary practice location

5115 E Lake Rd
Apt 206
Sheffield Lake, OH 44054-1751

Mailing address

5115 E Lake Rd
Apt 206
Sheffield Lake, OH 44054-1751
Phone (440) 785-8570

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
RN197890OHMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252886400000",
    "number": "1609109347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 E LAKE RD",
            "address_2": "APT 206",
            "city": "SHEFFIELD LAKE",
            "state": "OH",
            "postal_code": "440541751",
            "telephone_number": "440-785-8570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 E LAKE RD",
            "address_2": "APT 206",
            "city": "SHEFFIELD LAKE",
            "state": "OH",
            "postal_code": "440541751",
            "telephone_number": "440-785-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "VICKI",
        "middle_name": "JO",
        "name_prefix": "Miss",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-14",
        "last_updated": "2009-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "OH",
            "license": "RN197890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheffield Lake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; 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.