Individual provider Active NPI

Robert J. Smith, DO

  • General Practice Physician
  • Springboro, OH
National Provider Identifier
1760421408
Registry record updated Nov 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
34.003325 Issued in OH
Practice address
360 W Central Ave
Springboro, OH 45066-1106
Phone
(937) 208-7100
Fax
(937) 208-7125
NPI assigned
Jun 6, 2006
Last updated
Nov 13, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 34.003325 OH Primary

Addresses

Primary practice location

360 W Central Ave
Springboro, OH 45066-1106

Mailing address

360 W Central Ave
Springboro, OH 45066-1106
Phone (937) 208-7100

Other identifiers 1

IdentifierTypeStateIssuer
0649098MedicaidOH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100203000312 OH Practitioner - General Practice 2668515347 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.003325OHMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mvhe Inc CurrentSince Feb 1, 1993 Accepting new patients
Mvhe Inc Current Accepting new patients
Mvhe Inc CurrentSince Feb 1, 1993 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

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

360 W Central Ave
Springboro, OH 45066
Phone (937) 208-7100

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384300800000",
    "number": "1760421408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W CENTRAL AVE",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450661106",
            "telephone_number": "937-208-7100",
            "fax_number": "937-208-7125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W CENTRAL AVE",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450661106",
            "telephone_number": "937-208-7100",
            "fax_number": "937-208-7125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROBERT",
        "middle_name": "J.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2013-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "34.003325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0649098",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springboro, OH

Sources for this page

Verify at the official NPI Registry.