Individual provider Active NPI

Jonathan Smith, D.C.

  • Chiropractor
  • San Rafael, CA
National Provider Identifier
1033208699
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC26245 Issued in CA
Practice address
880 Las Gallinas Ave
6
San Rafael, CA 94903-3437
Phone
(949) 598-9999
Fax
(949) 598-9990
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC26245 CA Primary

Addresses

Primary practice location

880 Las Gallinas Ave
6
San Rafael, CA 94903-3437

Mailing address

880 Las Gallinas Ave Ste 6
San Rafael, CA 94903-3437
Phone (415) 499-3399

Other identifiers 1

IdentifierTypeStateIssuer
DC0262450OtherCABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041202001072 CA Practitioner - Chiropractic 7416913389 Practice locations: San Rafael, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

880 Las Gallinas Ave
San Rafael, CA 94903-3437
Phone (415) 499-3399

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC26245CAMDChiropractor
26245CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Remedy Medical Group PastSince Sep 3, 2025 Accepting new patients
California Pacific Medical Group, Inc. PastSince Sep 3, 2025 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1033208699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 LAS GALLINAS AVE STE 6",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033437",
            "telephone_number": "415-499-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 LAS GALLINAS AVE",
            "address_2": "6",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033437",
            "telephone_number": "949-598-9999",
            "fax_number": "949-598-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JONATHAN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC26245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "DC0262450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.