MEDICARE: MS. MELINDA 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	311ZA0620X	Adult Care Home Facility		OH

General Provider Information

NPI Number	:	1689549867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELINDA SMITH

Provider Business Mailing Address
First Line	:	1163 PONDVIEW AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44305-3332
Country	:	US
Telephone Number	:	330-283-0747
Fax Number	:

Provider Business Practice Location Address
First Line	:	1163 PONDVIEW AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44305-3332
Country	:	US
Telephone Number	:	330-283-0747
Fax Number	:

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

Provider Enumeration Date	:	10/08/2025
Last Update Date	:	01/29/2026

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