Active NPI
Jennifer Lynne Smith, CNP
- Adult Health Nurse Practitioner
- Cleveland, OH
National Provider Identifier
1821069931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- NP-08369
- Practice address
- 10701 East Blvd
Cleveland, OH 44106-1702 - Phone
- (216) 791-3800
- NPI assigned
- Jan 27, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | NP-08369 | OH | Primary |
Addresses
Primary practice location
10701 East Blvd
Cleveland, OH 44106-1702
Mailing address
10701 East Blvd
Cleveland, OH 44106-1702
Phone (216) 791-3800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000374306 | Other | OH | ANTHEM |
| 2594456 | Medicaid | OH |
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP-08369 | OH | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Care Health Network LLC | Current | Accepting new patients | |
| North Ohio Heart Center Inc | Adult Health | Past | Accepting new patients |
Locations
9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883
1690 Woodlands Dr
Ste 200
Maumee, OH 43537
Phone (419) 491-0420
Organizations & group practices 2
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": "1138320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585526400000",
"number": "1821069931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10701 EAST BLVD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441061702",
"telephone_number": "216-791-3800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10701 EAST BLVD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441061702",
"telephone_number": "216-791-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "JENNIFER",
"middle_name": "LYNNE",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-27",
"last_updated": "2020-03-30",
"certification_date": "2020-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "OH",
"license": "NP-08369",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000374306",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2594456",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.