Individual provider Active NPI

Marc E. Smith

  • Case Manager/Care Coordinator
  • Fairfield, OH
National Provider Identifier
1871122960
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
6570 Sosna Dr
Fairfield, OH 45014-2222
Phone
(513) 892-4673
Fax
(513) 737-1107
NPI assigned
Apr 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

6570 Sosna Dr
Fairfield, OH 45014-2222

Mailing address

6570 Sosna Dr
Fairfield, OH 45014-2222
Phone (513) 942-4673

Other practice location 1

10296 Springfield Pike Ste 500
Cincinnati, OH 45215-1194
Phone (513) 942-4555

Other identifiers 1

IdentifierTypeStateIssuer
2910854MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Decoach Team LLC CurrentSince Dec 27, 2020 Accepting new patients
Viaquest Home Health LLC PastSince Apr 1, 2020 Accepting new patients
Viaquest Psychiatric & Behavioral Solutions LLC Case Manager/Care Coordinator PastSince Apr 1, 2020 Accepting new patients
Decoach Team LLC PastSince Dec 27, 2020 Accepting new patients

Locations

6570 Sosna Dr
Fairfield, OH 45014
Phone (513) 942-4673

Organizations & group practices 4

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": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1871122960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6570 SOSNA DR",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450142222",
            "telephone_number": "513-942-4673",
            "fax_number": "513-737-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6570 SOSNA DR",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450142222",
            "telephone_number": "513-892-4673",
            "fax_number": "513-737-1107"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10296 Springfield Pike Ste 500",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452151194",
            "country_code": "US",
            "telephone_number": "513-942-4555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARC",
        "middle_name": "E.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2910854",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.