Matthew Bradley Smith, MD
Individual provider Active NPI Family Medicine Physician · Fredericktown, OH
NPI 1821032152 · NPPES record last updated Apr 2, 2008
Key facts
- NPI
- 1821032152
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 35.080703 (OH)
- Practice address
- 122 Columbus Rd
Fredericktown, OH 43019-1266 - Phone
- (740) 694-1261
- Fax
- (740) 694-7145
- NPI assigned
- Jun 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Medical College of Ohio, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Health Professionals of Holmes County, Inc.
Knox Community Hospital
Practice addresses (Care Compare)
1261 Wooster Rd
Suite 200
Millersburg, OH 44654-1570
Phone (330) 674-3333
1330 Coshocton Ave
Mount Vernon, OH 43050-1440
1490 Coshocton
Suite B
Mount Vernon, OH 43050-6099
Phone (740) 393-9111
1490 Coshocton Ave
Mount Vernon, OH 43050-6099
Phone (740) 393-9111
Hospital & facility affiliations
- Knox Community Hospital
- Pomerene Hospital
- Pomerene Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040715001449 | OH | Practitioner - Family Practice |
7810976594 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.080703 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Knox Community Hospital | Current | Accepting new patients | |
| Knox Emergency Services, LLC | Current |
Accepting new patients | |
| Knox Community Hospital | Current | Accepting new patients | |
| Knox Community Hospital | Current |
Accepting new patients | |
| Knox Community Hospital | Current | Accepting new patients | |
| Knox Community Hospital | Family Medicine | Current |
Accepting new patients |
Locations
1330 Coshocton Ave
Fl 5
Mount Vernon, OH 43050
Phone (740) 393-9040
1490 Coshocton Ave
Mount Vernon, OH 43050
Phone (740) 393-9111
1330 Coshocton Ave
Mount Vernon, OH 43050
Phone (740) 393-9019
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35.080703 | OH | Yes |
Addresses
Primary practice location
122 Columbus Rd
Fredericktown, OH 43019-1266
Mailing address
122 Columbus Rd
Fredericktown, OH 43019-1266
Phone (740) 694-1261
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2327520 | Medicaid | OH | |
| 000000228476 | Other | OH | ANTHEM BC/BS |
| 2236399 | Other | OH | UNITED HEALTHCARE OF OHIO |
Other names
- M Bradley Smith
Other providers in Fredericktown, OH
- Tyler Ruhl
- Deborah J Samples
- Laura J Segraves
- Jessica Singrey
- Diane Linda Smith
- Jerald Snelling
- Megan Snider
- Bradlee Steven Spence
- Jeffrey Clark Spencer
- Heather Marie Staton
All providers in Fredericktown, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.