Individual provider Active NPI

Jessica Smith

  • Acute Care Nurse Practitioner
  • Elyria, OH
National Provider Identifier
1669923207
Registry record updated Oct 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN.CNP.019978 Issued in OH
Practice address
1120 E Broad St
Elyria, OH 44035-6306
Phone
(440) 366-2239
Fax
(440) 365-1366
NPI assigned
Oct 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.019978 OH Primary

Addresses

Primary practice location

1120 E Broad St
Elyria, OH 44035-6306

Mailing address

578 N Leavitt Rd
Amherst, OH 44001-1131
Phone (440) 213-0858

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
I20161219001544 OH Practitioner - Nurse Practitioner 7911288501 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

630 E River St
Elyria, OH 44035-5981
Phone (440) 284-8600

Hospital & facility affiliations

  • University Hospitals - Elyria Medical Center Hospital, Elyria, OH, CCN 360145

Merit-based Incentive Payment System (MIPS)

Final score
81.19 of 100Reported as group
Quality
63.13
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc CurrentSince May 1, 2019 Accepting new patients
Emh Regional Medical Center Current Accepting new patients
Community Intensivists, LLC CurrentSince Apr 1, 2023 Accepting new patients
Community Hospitalist, LLC Acute Care CurrentSince Aug 1, 2020 Accepting new patients
University Primary Care Practices Inc Current Accepting new patients
Elyria Anesthesia Incorporated CurrentSince Jan 26, 2021 Accepting new patients
University Hospitals Medical Group Inc CurrentSince May 1, 2018 Accepting new patients
University Primary Care Practices Inc CurrentSince May 1, 2019 Accepting new patients
Hni Medical Services of Ohio, LLC CurrentSince Jan 1, 2022 Accepting new patients
Emh Regional Medical Center CurrentSince May 30, 2020 Accepting new patients

Locations

11100 Euclid Ave
Cleveland Heights, OH 44106

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

630 E River St
Elyria, OH 44035
Phone (440) 329-7450

860 E Broad St
Ste I
Elyria, OH 44035
Phone (440) 323-8458

125 E Broad St
Ste 119
Elyria, OH 44035
Phone (440) 329-5941

3700 Kolbe Rd
Lorain, OH 44053
Phone (440) 331-9520

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

27100 Chardon Rd
Richmond Hts, OH 44143
Phone (440) 585-6000

Interoperability endpoints

  • Direct secure messaging: jsmith28281@ehrdirect.uhhospitals.org

Organizations & group practices 10

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1669923207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 N LEAVITT RD",
            "city": "AMHERST",
            "state": "OH",
            "postal_code": "440011131",
            "telephone_number": "440-213-0858",
            "fax_number": "440-988-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 E BROAD ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356306",
            "telephone_number": "440-366-2239",
            "fax_number": "440-365-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-19",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.019978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

Verify at the official NPI Registry.