Individual provider Active NPI

Zachary Kenneth Earl Smith, PA-S

  • Physician Assistant
  • Lima, OH
National Provider Identifier
1962754754
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.007066RX Issued in OH
Practice address
770 W High St Ste 160
Lima, OH 45801-5900
Phone
(419) 996-5224
Fax
(419) 996-5276
NPI assigned
Oct 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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 50.007066RX OH Primary

Addresses

Primary practice location

770 W High St Ste 160
Lima, OH 45801-5900

Mailing address

PO Box 639982
Cincinnati, OH 45263-9982

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210813003150 OH Practitioner - Physician Assistant 7719381672 Reassigns benefits to 2 organizations
I20230811001609 MI Practitioner - Physician Assistant 7719381672 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
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)

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4000

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

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.007066RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Physician Assistant CurrentSince Jul 1, 2025 Accepting new patients
Promedica Central Physicians CurrentSince Jul 1, 2025 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

830 W High St
Ste 390
Lima, OH 45801
Phone (419) 995-4960

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

Organizations & group practices 6

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.

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": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1962754754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639982",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 W HIGH ST STE 160",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458015900",
            "telephone_number": "419-996-5224",
            "fax_number": "419-996-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ZACHARY",
        "middle_name": "KENNETH EARL",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-04",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007066RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.