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Richele Smart

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

4240 Munson St NW, Canton, OH 44718-2978

PECOS Enrollment

Based on the most recent information from CMS, provider Richele Smart is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1013577709
Provider Type
Individual
Full Name
Smart, Richele
Gender
Female

Sole Proprietor
No
Enumeration Date
6/16/2019
Last Updated
6/16/2019

Contact Information

Practice Location

4240 Munson St NW, Canton, OH 44718-2978

(330) 491-8000

Unlisted Fax

Mailing Location

4240 Munson St NW, Canton, OH 44718-2978

(330) 491-8000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 024373 Ohio

Richele Smart

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Ham, Sirilak

Burkey, Lindsay Lynn

Karg, Lora Lou

Lee, Sia

Deem, Kimberly

Baldwin, Carmen

Berg, Melissa

Cochran, Candace

Casto, Rhonda J

Gainer, Joseph Richard