Johnelle R Smith, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

4301078591 Issued in MI

Practice address

1180 Beacon St
Ste 3C
Brookline, MA 02446-3806

Phone

(617) 202-9222

Fax

(617) 879-0933

NPI assigned

Feb 7, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1297036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1023314143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 BEACON ST",
            "address_2": "STE 3C",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463806",
            "telephone_number": "617-202-9222",
            "fax_number": "617-879-0933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 BEACON ST",
            "address_2": "STE 3C",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463806",
            "telephone_number": "617-202-9222",
            "fax_number": "617-879-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOHNELLE",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-07",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301078591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smile Dental, PC
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• Smile Solution Specialist
• Smile Solutions
• Smileboston Cosmetic and Implant Dentistry
• Kerrisa Lynn Smith, PT
• Megan J Smith, LCSW
• Natasha Faria Smith, LICSW
• Phillip Smith, M.D.
• Sarah Jane Smith, LMHC

• Physical Medicine & Rehabilitation Physician in Brookline, MA
• Providers in Brookline, MA by specialty
• Physical Medicine & Rehabilitation Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.