Active NPI
Maxine M Smith, RD
- Registered Dietitian
- Cleveland, OH
National Provider Identifier
1891734919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD2726
- Practice address
- 9500 Euclid Ave
Cleveland, OH 44195-0001 - Phone
- (800) 223-2273
- NPI assigned
- Jun 5, 2006
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD2726 | OH | Primary |
Addresses
Primary practice location
9500 Euclid Ave
Cleveland, OH 44195-0001
Mailing address
7825 N Gannett Rd
Sagamore Hills, OH 44067-2921
Phone (330) 468-4062
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7753436 | Other | OH | ANTARES PIN |
| 000000393115 | Other | OH | ANTHEM PIN |
| 7429813 | Other | OH | AETMA PIN # |
| 124252 | Other | OH | KAISER PIN |
| 7753436 | Other | OH | AETNA GROUP PIN# |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD2726 | OH | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Nordonia Hills Clinic Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Sagamore Hills, OH
- NPI 1871571091
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1891734919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7825 N GANNETT RD",
"city": "SAGAMORE HILLS",
"state": "OH",
"postal_code": "440672921",
"telephone_number": "330-468-4062",
"fax_number": "216-445-4356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 EUCLID AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441950001",
"telephone_number": "800-223-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "MAXINE",
"middle_name": "M",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "LD2726",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTARES PIN",
"identifier": "7753436",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PIN",
"identifier": "000000393115",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETMA PIN #",
"identifier": "7429813",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER PIN",
"identifier": "124252",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA GROUP PIN#",
"identifier": "7753436",
"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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.