NPIMap

Individual provider Active NPI

Kirk Ellis Smith, DO

  • Family Medicine Physician
  • Middletown, OH
National Provider Identifier
1730199985
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34004607 Issued in OH
Practice address
5005 Kilkerry Dr
Middletown, OH 45042-3004
Phone
(937) 641-0447
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34004607 OH Primary

Addresses

Primary practice location

5005 Kilkerry Dr
Middletown, OH 45042-3004

Mailing address

5005 Kilkerry Dr
Middletown, OH 45042-3004

Other practice location 1

2403 Central Ave.
Middletown, OH 45044
Phone (513) 423-1211

Other practice location 2

200 Medical Center Dr Ste 300
Middletown, OH 45005
Phone (513) 423-1211

Other identifiers 3

IdentifierTypeStateIssuer
0764801MedicaidOH
0120017OtherOHUHC
000000016049OtherOHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080523000239 OH Practitioner - Family PracticePractitioner - Hospice/Palliative CarePractitioner - Geriatric Medicine 7618046178 Reassigns benefits to 1 organization
Practice locations: Middletown, OH

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine, Hospice/Palliative Care
Education
Ohio University, College of Osteopathic Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5005 Kilkerry Dr
Middletown, OH 45042-3004
Phone (937) 641-0447

Hospital & facility affiliations

  • Ohio Valley Hospice Hospice, Beavercreek, OH, CCN 361647
  • Hospice of Dayton Hospice, Dayton, OH, CCN 361501
  • Hillspring Health Care & Rehab Nursing home, Springboro, OH, CCN 366185
  • Astoria Health & Rehab Center Nursing home, Germantown, OH, CCN 366291
  • Liberty Nursing Center of Colerain Inc Nursing home, Cincinnati, OH, CCN 366427

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34004607OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mvhe Inc Family Medicine Current Accepting new patients
Mvhe, Inc CurrentSince Aug 29, 2018 Accepting new patients
Mvhe Inc CurrentSince Aug 29, 2018 Accepting new patients
CT Ohio Dayton-Centerville LLC Past Accepting new patients
Franklin Rehab LLC Past Accepting new patients
Hillspring Health Care Center, LLC Past Accepting new patients
Astoria Healthcare Group, LLC Past Accepting new patients

Locations

722 N Fairfield Rd
Beavercreek, OH 45434
Phone (937) 208-7000

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

200 Medical Center Dr
Ste 300
Middletown, OH 45005
Phone (513) 423-1211

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

Interoperability endpoints

  • Direct secure messaging: kirk.smith.1@24808.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Astoria Health & Rehab CenterGermantown, OH, CCN 366291 Skilled nursing facility Adp of the SNF Jan 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 5

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1730199985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 KILKERRY DR",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 KILKERRY DR",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423004",
            "telephone_number": "937-641-0447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2403 Central Ave.",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "45044",
            "country_code": "US",
            "telephone_number": "513-423-1211",
            "fax_number": "513-423-5845",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Medical Center Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "45005",
            "country_code": "US",
            "telephone_number": "513-423-1211",
            "fax_number": "513-423-5845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIRK",
        "middle_name": "ELLIS",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34004607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0764801",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "0120017",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000016049",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

Verify at the official NPI Registry.