Jamie Michelle Wallace Smith, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

39137 Issued in IA

Practice address

107 1St St NE
Mount Vernon, IA 52314-1422

Phone

(319) 895-1620

NPI assigned

Jun 22, 2009

Last updated

Nov 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jamie Michelle Wallace Professional name

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Iowa, RJ & L Carver College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Hospital Hospital, Cedar Rapids, IA, CCN 160045
• Jones Regional Medical Center Hospital, Anamosa, IA, CCN 161306
• Mercy Medical Center - Cedar Rapids Hospital, Cedar Rapids, IA, CCN 160079

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jamie.smith@737874562514948.direct.elationemr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mount Vernon Family Medicine, PC

  • Health Service Clinic/Center
  • Mount Vernon, IA
  • NPI 1972357325
  Medicare reassignment NPD
• Genesis Health System

  dba Genesis Family Medical Center

  • Family Medicine Physician
  • Davenport, IA
  • NPI 1922012764
  NPD (past)
• Genesis Medical Education Foundation Inc

  dba Genesis Family Medical Center

  • Family Medicine Physician
  • Davenport, IA
  • NPI 1659322931
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Medical Center

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1720029333
  Care Compare affiliation
• St Luke's Jones Regional Medical Center

  • Critical Access Hospital
  • Anamosa, IA
  • NPI 1164514741
  Care Compare affiliation
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1013144674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 1ST ST NE",
            "city": "MOUNT VERNON",
            "state": "IA",
            "postal_code": "523141422",
            "telephone_number": "319-895-1620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 1ST ST NE",
            "city": "MOUNT VERNON",
            "state": "IA",
            "postal_code": "523141422",
            "telephone_number": "319-895-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JAMIE",
        "middle_name": "MICHELLE WALLACE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R8646",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "39137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013144674",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "WALLACE",
            "middle_name": "MICHELLE",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Amy Jo Scallon, DDS
• Clayton T Schuett, DO
• Steven Sindt
• Richard Skotowski
• Rebekah Sloan
• Jessica Soria
• Presley Joyce Tapken, T-LMHC
• Samantha Nichole Thurn, M.S., BCBA
• Tiffany Zarifkar, LMHC, LLC (Mount Vernon Family Counseling)
• Lisa Tortora

• Family Medicine Physician in Mount Vernon, IA
• Providers in Mount Vernon, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.