MEDICARE: MS. KAY A SMITH CNM

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	176B00000X	Midwife	04991	OH
2	363LW0102X	Women's Health Nurse Practitioner	NP02845	OH
3	367A00000X	Advanced Practice Midwife	NM04991	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	05225	OTHER	OH	PARAMOUNT
2	344428256	OTHER	OH	BEECHSTREET
3	344428256074	OTHER	OH	CARESOURCE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	344428256	OTHER	OH	FRONTPATH
6	000000064890	OTHER	OH	ANTHEM
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497753297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAY A SMITH CNM

Provider Business Mailing Address
First Line	:	2751 BAY PARK DR
Second Line	:	SUITE 300
City	:	OREGON
State	:	OH
Zip	:	43616-4921
Country	:	US
Telephone Number	:	419-690-7596
Fax Number	:	419-697-6707

Provider Business Practice Location Address
First Line	:	2751 BAY PARK DR
Second Line	:	SUITE 300
City	:	OREGON
State	:	OH
Zip	:	43616-4921
Country	:	US
Telephone Number	:	419-690-7596
Fax Number	:	419-697-6707

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	11/03/2023

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Directions to “ MS. KAY A SMITH CNM” Practice Location

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