Active NPI
Dale Smith
- Community Health Worker
- Warsaw, OH
National Provider Identifier
1972042869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 1601672
- Practice address
- 36578 Township Road 131
Warsaw, OH 43844-9544 - Phone
- (740) 294-8963
- NPI assigned
- Feb 13, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 1601672 | OH | Primary |
Addresses
Primary practice location
36578 Township Road 131
Warsaw, OH 43844-9544
Mailing address
36578 Township Road 131
Warsaw, OH 43844
Phone (740) 294-8963
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1601672 | OH | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486944000000",
"number": "1972042869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36578 TOWNSHIP ROAD 131",
"city": "WARSAW",
"state": "OH",
"postal_code": "43844",
"telephone_number": "740-294-8963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36578 TOWNSHIP ROAD 131",
"city": "WARSAW",
"state": "OH",
"postal_code": "438449544",
"telephone_number": "740-294-8963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "DALE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-13",
"last_updated": "2017-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OH",
"license": "1601672",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warsaw, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.