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NPI Code Detail

MEDICARE: THERESA M. SMILEY

MEDICARE: THERESA M. SMILEY
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
1171M00000XCase Manager/Care Coordinator
23747A0650XAttendant Care Provider

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659123032
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA M. SMILEY
Provider Business Mailing Address
First Line : 9209 GRAND DIVISION AVE # 9
Second Line :
City : CLEVELAND
State : OH
Zip : 44125-1353
Country : US
Telephone Number : 440-538-4564
Fax Number :
Provider Business Practice Location Address
First Line : 10400 BLACKLICK EASTERN RD
Second Line :
City : PICKERINGTON
State : OH
Zip : 43147-8235
Country : US
Telephone Number : 440-538-4564
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2024
Last Update Date : 02/11/2026

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