Individual provider Active NPI

Kathleene Anne Smachlo, M.D.

  • Internal Medicine Physician
  • Cleveland, OH
National Provider Identifier
1699896696
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35050899-S Issued in OH
Practice address
10900 Euclid Ave
Cleveland, OH 44106-1712
Phone
(216) 368-2457
Fax
(216) 368-8548
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35050899-S OH Primary

Addresses

Primary practice location

10900 Euclid Ave
Cleveland, OH 44106-1712

Mailing address

2854 Sedgewick Rd
Shaker Heights, OH 44120-1838
Phone (216) 751-6207

Other identifiers 1

IdentifierTypeStateIssuer
0709531MedicaidOH

Other names 1

  • Dr. Kathy Anne Smachlo Other name

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35050899-SOHMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699896696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2854 SEDGEWICK RD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441201838",
            "telephone_number": "216-751-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061712",
            "telephone_number": "216-368-2457",
            "fax_number": "216-368-8548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMACHLO",
        "first_name": "KATHLEENE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35050899-S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0709531",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "SMACHLO",
            "middle_name": "ANNE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.