DENISE M SMITH (NPI# 1912907445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912907445 |
| Entity Type | Individual |
| Full Name | DENISE M SMITH |
| Credential | DO |
| Practice Address |
1211 W State Blvd Fort Wayne IN 46808-3103 |
| Practice Telephone | 2604220010 |
| Practice Fax Number | 2604222212 |
| Mailing Telephone | 2604220010 |
| Mailing Fax Number | 2604222212 |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2020-09-21 |
| NPI Deactivation Date | 03/21/2006 |
| NPI Reactivation Date | 2006-04-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 02001605 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | RAILROAD MEDICARE | 080175244 | 01 |
| IN | 200023850 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7333 W Jefferson Blvd, Fort Wayne, IN 468046280 | 2604583830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497383004 | Denise E Smith | Counselor | 636 Saint Johns Rd, Drums, PA 18222-1617 | 2020-03-30 |
| 1962920785 | Denise R Smith | Nurse Practitioner | 2025 Virginia Ave., Ste. D, Connersville, IN 47331-2914 | 2017-08-31 |
| 1669918140 | Denise Smith | Counselor | 7876 102nd Ave, 102, Vero Beach, FL 32966-3292 | 2017-01-09 |
| 1780129627 | Denise Smith | Licensed Practical Nurse | 14 Fox Ter, Poughkeepsie, NY 12603-2729 | 2017-01-02 |
| 1700272630 | Denise Smith | Case Manager/Care Coordinator | 3217 Lawnview Ave, Baltimore, MD 21213-1627 | 2015-04-07 |
| 1588066823 | Denise D Smith | Speech-Language Pathologist | 573 Laurel Grove Ct, Cincinnati, OH 45244-1448 | 2014-09-18 |
| 1730595562 | Denise Smith | Specialist/Technologist | 102 Heritage Ln, Stroudsburg, PA 18360-8579 | 2014-07-01 |
| 1902162670 | Denise Smith | Home Health Aide | 640 Girard St Ne Apt 4, Washington, DC 20017-1326 | 2012-04-07 |
| 1376813030 | Denise L Smith | Speech-Language Pathologist | 25 County Route 27b, Hudson, NY 12534-3921 | 2012-01-11 |
| 1023391745 | Denise D Smith | Developmental Therapist | 4086 De Reimer Ave, Bronx, NY 10466-2321 | 2011-09-20 |
| Street Address |
1211 W STATE BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46808-3103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548214109 | Mary Esther Elias | Nurse Practitioner | 1211 W State Blvd, Fort Wayne, IN 46808-3103 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347102 | Austin Hartzog | Pharmacist | 5110 Value Drive, Fort Wayne, IN 46808 | 2020-08-21 |
| 1407358377 | Bryan Black | Specialist/Technologist | 3946 Ice Way Fort Wayne, Fort Wayne, IN 46808 | 2018-03-06 |
| 1326557877 | Kimberly K Kolb | Occupational Therapy Assistant | 1431 Runnion Ave, Fort Wayne, IN 46808 | 2017-09-28 |
| 1396142063 | Christina Ryder | Specialist/Technologist | 3946 Iceway, Fort Wayne, IN 46808 | 2014-11-25 |
| 1912090440 | Neighborcare of Indiana, LLC | Pharmacy | 3402 Congressional Pkwy, Ft. Wayne, IN 46808 | 2006-10-02 |
| 1619945888 | Beth Ann Herrell | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2006-03-14 |
| 1568458990 | Carolyn Warner Greer | Obstetrics & Gynecology | 1415 Directors Row, Fort Wayne, IN 46808 | 2005-09-21 |
| 1750851168 | Tyler Cheney | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2018-11-28 |
| 1487123550 | Michaela Mcguire | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2018-11-19 |
| 1861961088 | Olivia Marquardt | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2018-11-16 |
| Find all providers in zip 46808 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760912026 | Christina A Tatara | Family Medicine | 6511 E State Blvd, Fort Wayne, IN 46815-7026 | 2017-06-19 |
| 1700317633 | Robert Campbell | Family Medicine | 7411 Hope Dr, Fort Wayne, IN 46815-5687 | 2017-03-22 |
| 1487196424 | American Vein Institute LLC | Family Medicine | 10020 Dupont Circle Ct Ste 140, Fort Wayne, IN 46825-1621 | 2016-11-08 |
| 1831547124 | Anna Menze | Family Medicine | 10307 Dupont Circle Dr W Ste A, Fort Wayne, IN 46825-1633 | 2016-05-27 |
| 1407203672 | Credo Health Group, LLC | Family Medicine | 10228 Dupont Circle Dr E # 100b, Fort Wayne, IN 46825-1611 | 2016-05-18 |
| 1649625104 | Gabrielle Paloma Acquaro | Family Medicine | 7806 W Jefferson Blvd Ste E, Fort Wayne, IN 46804-4180 | 2016-05-03 |
| 1720491731 | John E Marx | Family Medicine | 1007 W Rudisill Blvd, Fort Wayne, IN 46807-2170 | 2014-06-06 |
| 1457763252 | Amy Simpson | Family Medicine | 1818 Carew St Ste 120, Fort Wayne, IN 46805-4764 | 2014-05-28 |
| 1932536083 | Clifford James Shultz | Family Medicine | 2616 Covington Pointe Trl, Fort Wayne, IN 46804-2773 | 2013-10-03 |
| 1164860086 | Andrew J Mullally | Family Medicine | 10050 Auburn Park Dr, Fort Wayne, IN 46825-2389 | 2013-06-13 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46808 |
Please comment or provide details below to improve the information on DENISE M SMITH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.