NPIMap

Individual provider Active NPI

Kellie K Smith, MD

  • Internal Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1982668612
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35065777 Issued in OH
Practice address
9050 Montgomery Road
Suite B
Cincinnati, OH 45242-7740
Phone
(513) 631-6963
Fax
(513) 631-1970
NPI assigned
Apr 12, 2006
Last updated
Jun 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35065777 OH Primary
Hospitalist Physician 208M00000X 35065777 OH

Addresses

Primary practice location

9050 Montgomery Road
Suite B
Cincinnati, OH 45242-7740

Mailing address

9050 Montgomery Road
Suite B
Cincinnati, OH 45242-7740
Phone (513) 631-6963

Other identifiers 2

IdentifierTypeStateIssuer
P00790119OtherOHRAILROAD MEDICARE PIN
0996052MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060130000027 OH Practitioner - Internal Medicine 4284537812 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Vanderbilt University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oxford Physical Therapy and RehabilitationGroup PAC ID 0244232874, 432 clinicians
My Doctor, LLCGroup PAC ID 0749257707, 4 clinicians

Practice addresses (Care Compare)

7567 Central Parke Blvd
A
Mason, OH 45040-6852

9050 Montgomery Rd
Suite B
Cincinnati, OH 45242-7747
Phone (513) 631-6963

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35065777OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trihealth G, LLC CurrentSince Jan 1, 2016 Accepting new patients
Trihealth G LLC Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
My Doctor, LLC Internal Medicine CurrentSince Sep 1, 2007 Accepting new patients
Trihealth Physician Institute Hospitalist Past Accepting new patients
University Surgical-Dental Associates, LLC Past Accepting new patients
University of Cincinnati Physicians Company, LLC Internal Medicine Past Accepting new patients

Locations

2001 Anderson Ferry Rd
Cincinnati, OH 45238
Phone (513) 922-1200

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

375 Dixmyth Ave
Ste 3135
Cincinnati, OH 45220
Phone (513) 862-3452

9050 Montgomery Rd
Ste B
Cincinnati, OH 45242
Phone (513) 631-6963

9070 Winton Rd
Cincinnati, OH 45231
Phone (513) 246-2750

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

Interoperability endpoints

  • Direct secure messaging: kellie.smith.1@1702.direct.athenahealth.com

Organizations & group practices 7

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 11

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1982668612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9050 MONTGOMERY ROAD",
            "address_2": "SUITE B",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452427740",
            "telephone_number": "513-631-6963",
            "fax_number": "513-631-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9050 MONTGOMERY ROAD",
            "address_2": "SUITE B",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452427740",
            "telephone_number": "513-631-6963",
            "fax_number": "513-631-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELLIE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35065777",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35065777",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00790119",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0996052",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.