Jeremy Smith, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

1031928 Issued in TX

Practice address

10009 Chadbourne Rd
Fort Worth, TX 76244-9589

Phone

(304) 483-0212

NPI assigned

Nov 4, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1013624451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 COLLEGE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10009 CHADBOURNE RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762449589",
            "telephone_number": "304-483-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEREMY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "382473",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1031928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jana Smith, RN
• Jane B Smith, OTR
• Jared Taylor Smith, PA-C
• Jeanette Tello Smith, LSSP
• Jeffrey M Smith, LPC
• Jeremy Smith
• Jesse E Smith, MD
• Jessica Smith
• Jimmy Dale Smith, PT, DPT
• Jo Bartell Smith, LPA

• Registered Nurse in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.