Healthcare Provider Details

I. General information

NPI: 1629908819
Provider Name (Legal Business Name): JAYVONTEA SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7868 MEADOWHAVEN BLVD
COLUMBUS OH
43235-1888
US

IV. Provider business mailing address

7868 MEADOWHAVEN BLVD
COLUMBUS OH
43235-1888
US

V. Phone/Fax

Practice location:
  • Phone: 380-998-5646
  • Fax: 380-998-5646
Mailing address:
  • Phone: 380-998-5646
  • Fax: 380-998-5646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: