Individual provider Active NPI

Martha Smith

  • Psychiatric/Mental Health Nurse Practitioner
  • Delaware, OH
National Provider Identifier
1619590908
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0027707 Issued in OH
Practice address
246 Knight Dream St
Delaware, OH 43015-3404
Phone
(740) 936-7259
NPI assigned
May 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0027707 OH Primary

Addresses

Primary practice location

246 Knight Dream St
Delaware, OH 43015-3404

Mailing address

246 Knight Dream St
Delaware, OH 43015-3404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201222002099 OH Practitioner - Nurse Practitioner 3870905557 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

125 Executive Dr
Suite 201
Marion, OH 43302-6302

136 W Ctr St
Marion, OH 43302-3704

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0027707OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Center Street Community Clinic, Inc CurrentSince Jun 15, 2021 Accepting new patients
Center Street Community Clinic Inc CurrentSince Jun 15, 2021 Accepting new patients
Right Path Recovery LLC CurrentSince Nov 8, 2021 Accepting new patients
Rejuvenated Mind Psychiatric/Mental Health Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1050 Kingsmill Pkwy
Columbus, OH 43229
Phone (614) 854-0300

136 W Center St
Marion, OH 43302
Phone (740) 751-4531

125 Executive Dr
Ste 201
Marion, OH 43302
Phone (614) 387-4090

Interoperability endpoints

  • Direct secure messaging: martha.smith@rprl-oh.direct.office.nextgen.com

Organizations & group practices 5

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": "1590019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1619590908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 KNIGHT DREAM ST",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430153404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 KNIGHT DREAM ST",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430153404",
            "telephone_number": "740-936-7259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-21",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0027707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delaware, OH

Sources for this page

Verify at the official NPI Registry.