Shelly Regine Smith

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

77 E Woodbury Dr Ste 110
Dayton, OH 45415-2853

Phone

(937) 569-8552

NPI assigned

Mar 26, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1992382899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 E WOODBURY DR STE 110",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454152853",
            "telephone_number": "937-569-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 E WOODBURY DR STE 110",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454152853",
            "telephone_number": "937-569-8552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 N Vandemark Rd",
            "address_purpose": "LOCATION",
            "city": "Sidney",
            "state": "OH",
            "postal_code": "453653567",
            "country_code": "US",
            "telephone_number": "937-710-4616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHELLY",
        "middle_name": "REGINE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-26",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992382899",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosemary Smith, CRNA
• Sarah Elizabeth Smith
• Savannah Grace Smith
• Shane William Smith, R.N.
• Shannon Smith
• Sherri Lynee Smith, DNP, APRN, AGACNP-BC
• Sierra Smith
• Stacey Smith, MA, LSW
• Susan Mary Smith, RN, CNS, BC, ONC
• Sydney Smith

• Addiction (Substance Use Disorder) Counselor in Dayton, OH
• Providers in Dayton, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.