Individual provider Active NPI

Katheryn M Smolen, MD

  • Internal Medicine Physician
  • Perrysburg, OH
National Provider Identifier
1811973688
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35074631S Issued in OH
Practice address
28276 Kensington LN
Perrysburg, OH 43551-4178
Phone
(419) 843-4422
NPI assigned
Dec 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 35.074631 OH
Internal Medicine Physician 207R00000X 35074631S OH Primary

Addresses

Primary practice location

28276 Kensington LN
Perrysburg, OH 43551-4178

Mailing address

28276 Kensington LN
Perrysburg, OH 43551-4178
Phone (419) 843-4422

Other identifiers 4

IdentifierTypeStateIssuer
000000142295OtherOHANTHEM
110211982OtherOHRAILROAD MEDICARE
2113724MedicaidOH
03558OtherOHPARAMOUNT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090331000629 OH Practitioner - Internal Medicine 5597659078 Reassigns benefits to 1 organization
I20130201000220 MI Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 5597659078 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35074631SOHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice of Northwest Ohio PastSince Mar 1, 2020 Accepting new patients
Internal Medicine Consultants of Northwest Ohio LTD Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1811973688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28276 KENSINGTON LN",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435514178",
            "telephone_number": "419-843-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28276 KENSINGTON LN",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435514178",
            "telephone_number": "419-843-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLEN",
        "first_name": "KATHERYN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "OH",
            "license": "35.074631",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35074631S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000142295",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110211982",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2113724",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "03558",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.