Individual provider Active NPI

Holly L Smith, P.A.

  • Physician Assistant
  • Sylvania, OH
National Provider Identifier
1942214085
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50002077 Issued in OH
Practice address
5700 Monroe St Unit 111
Sylvania, OH 43560-2779
Phone
(567) 585-0005
Fax
(567) 585-0007
NPI assigned
Jul 27, 2006
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50002077 OH Primary

Addresses

Primary practice location

5700 Monroe St Unit 111
Sylvania, OH 43560-2779

Mailing address

1 Seagate Ste 800
Toledo, OH 43604-1558
Phone (567) 585-0005

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hsmith13249@epicdirect.promedica.org

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040309001362 OH Practitioner - Physician Assistant 4789572876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

2109 Hughes Dr
Suite 450
Toledo, OH 43606-5102
Phone (419) 291-2003

2901 N Reynolds Rd
Toledo, OH 43606
Phone (419) 578-7700

3316 Navarre Ave
Suite F
Oregon, OH 43616-3314
Phone (419) 291-1420

3430 Secor Rd
Suite 425
Toledo, OH 43606-1547
Phone (567) 585-0225

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50002077OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Physician Assistant CurrentSince Dec 1, 2018 Accepting new patients
Promedica Central Physicians CurrentSince Dec 1, 2018 Accepting new patients

Locations

5700 Monroe St
Unit 111
Sylvania, OH 43560
Phone (567) 585-0005

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

2865 N Reynolds Rd
Bldg A
Toledo, OH 43615
Phone (419) 578-4200

Interoperability endpoints

  • Direct secure messaging: hsmith13249@direct.promedica.org

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1942214085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SEAGATE STE 800",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041558",
            "telephone_number": "567-585-0005",
            "fax_number": "567-585-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 MONROE ST UNIT 111",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602779",
            "telephone_number": "567-585-0005",
            "fax_number": "567-585-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "HOLLY",
        "middle_name": "L",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50002077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hsmith13249@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.