MEDICARE: JODI SMITH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator		OH

General Provider Information

NPI Number	:	1346179801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JODI SMITH

Provider Business Mailing Address
First Line	:	5910 OLD SPRINGFIELD RD
Second Line	:
City	:	SOUTH CHARLESTON
State	:	OH
Zip	:	45368-9742
Country	:	US
Telephone Number	:	937-561-4384
Fax Number	:

Provider Business Practice Location Address
First Line	:	5910 OLD SPRINGFIELD RD
Second Line	:
City	:	SOUTH CHARLESTON
State	:	OH
Zip	:	45368-9742
Country	:	US
Telephone Number	:	937-561-4384
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/22/2026

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Directions to “ JODI SMITH ” Practice Location

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