Shani Kamaria Smith, D.O., M.B.A.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036.130820 Issued in IL

Practice address

3700 W 203Rd St Ste 204
Olympia Fields, IL 60461-1182

Phone

(708) 709-6295

NPI assigned

Dec 21, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in IL, ID, MO, MD, DC5 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 5

Specialty

Critical Care (Intensivists)

Education

Philadelphia College of Osteopathic Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Johns Hopkins Community Physicians, IncGroup PAC ID 8325943707, 764 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Johns Hopkins Howard County Medical Center Hospital, Columbia, MD, CCN 210048
• St Luke's Regional Medical Center Hospital, Boise, ID, CCN 130006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Master of Business Administration

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssmith592177@direct.franciscanalliance.org
• Direct secure messaging: ssmith197272@direct-ehr-ssmhc.com
• Direct secure messaging: ssmith1185933@direct.hopkinsmedicine.org

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.

• Johns Hopkins Community Physicians, Inc

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1578598868

  DC

  Medicare reassignment Care Compare group NPD
• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• Cep America Illinois Intensivists

  • Critical Care Medicine (Internal Medicine) Physician
  • Elgin, IL
  • NPI 1821641499
  Medicare reassignment NPD
• Critical Care Physicians of Illinois LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Aurora, IL
  • NPI 1508134966
  Medicare reassignment NPD
• Rockford Health Physicians

  dba Mercyhealth Physicians

  • Multi-Specialty Clinic/Center
  • Rockford, IL
  • NPI 1043242886
  Medicare reassignment NPD
• Cogent Healthcare of Missouri, Inc

  • Critical Care Medicine (Internal Medicine) Physician
  • Fenton, MO
  • NPI 1780961599
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Maryland-Laurel PC

  • Critical Care Medicine (Internal Medicine) Physician
  • Frederick, MD
  • NPI 1316554587
  Medicare reassignment NPD
• Cep America Illinois Intensivists

  • Critical Care Medicine (Internal Medicine) Physician
  • Kankakee, IL
  • NPI 1174320873
  NPD
• Cep America Illinois Intensivists

  • Critical Care Medicine (Internal Medicine) Physician
  • Effingham, IL
  • NPI 1538661475
  NPD
• RMH Pathologists, LTD

  • Anatomic Pathology Physician
  • Rockford, IL
  • NPI 1184671992
  NPD
• Johns Hopkins Community Physicians

  dba JHCP- 6225 Smith Avenue; Mental Health Therapy

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1356161806

  Internal Medicine

  NPD
• Johns Hopkins Community Physicians, Inc

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1255359972
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Howard County General Hospital, Inc,

  dba Johns Hopkins Howard County Medical Center

  • General Acute Care Hospital
  • Columbia, MD
  • NPI 1144291899
  Care Compare affiliation
• St Lukes Regional Medical Center

  dba Air St Luke's

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation

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

{
    "created_epoch": "1292889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1659674240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35318 EAGLE WAY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606781353",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 W 203RD ST STE 204",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611182",
            "telephone_number": "708-709-6295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "917 W Washington Blvd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606072203",
            "country_code": "US",
            "telephone_number": "555-555-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHANI",
        "middle_name": "KAMARIA",
        "credential": "D.O., M.B.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-21",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.130820",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036.130820",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.130820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE IL PTAN",
            "identifier": "F00280905",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "700 S Park St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssmith592177@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3700 W 203rd St Ste 204",
            "city": "Olympia Fields",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604611182",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssmith197272@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ssmith197272@direct-ehr-ssmhc.com",
            "address_1": "700 S Park St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kira Slager, PTA
• Alphonso J Slaughter Jr., MS
• Alyson Brooke Smith, DO
• Beverly Ann Smith, LCSW
• Cheri Lynn Smith, MHS-CCC SLP
• Zakette Smith
• Robin Dale Snead, M.D.
• Georgia Soltau, LCPC
• Samiratou Soudre, APRN
• South Suburban Arthritis Group SC

• Internal Medicine Physician in Olympia Fields, IL
• Providers in Olympia Fields, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.