Active NPI
Patricia Ann Smethurst, MD
- Family Medicine Physician
- Maumee, OH
National Provider Identifier
1700812443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35-050480
- Practice address
- 1715 Indian Wood Cir
Ste 200, Office 266 & 255
Maumee, OH 43537-4055 - Phone
- (419) 578-8594
- Fax
- (855) 618-2622
- NPI assigned
- Jun 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35-050480 | OH | Primary |
| Pediatrics Physician | 208000000X | 4301051752 | MI | |
| General Practice Physician | 208D00000X | 4301051752 | MI |
Addresses
Primary practice location
1715 Indian Wood Cir
Ste 200, Office 266 & 255
Maumee, OH 43537-4055
Mailing address
PO Box 1239
Troy, MI 48099-1239
Phone (248) 824-6600
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00066885 | Other | OH | RAILROAD |
| 0590123 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35-050480 | OH | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399507200000",
"number": "1700812443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1239",
"city": "TROY",
"state": "MI",
"postal_code": "480991239",
"telephone_number": "248-824-6600",
"fax_number": "248-324-1477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1715 INDIAN WOOD CIR",
"address_2": "STE 200, OFFICE 266 & 255",
"city": "MAUMEE",
"state": "OH",
"postal_code": "435374055",
"telephone_number": "419-578-8594",
"fax_number": "855-618-2622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMETHURST",
"first_name": "PATRICIA",
"middle_name": "ANN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-24",
"last_updated": "2014-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35-050480",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301051752",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "MI",
"license": "4301051752",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P00066885",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0590123",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maumee, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.