Jacob Smith

Primary specialty

ContractorTaxonomy code 171W00000X

Practice address

960 W Southern Ave Apt 2006
Mesa, AZ 85210-4968

Phone

(602) 488-6496

NPI assigned

Sep 10, 2020

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1043825698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 W SOUTHERN AVE APT 2006",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104968",
            "telephone_number": "602-488-6496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 W SOUTHERN AVE APT 2006",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104968",
            "telephone_number": "602-488-6496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACOB",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emmaline Smith
• Gregg Alan Smith, D.O.
• Gregory Reed Smith, PHARMD.
• Hosteen Smith
• Isaac Smith
• Jacqueline Sue Smith, RN
• Jared Spencer Smith, DMD
• Jasmine Smith
• Jason B Smith, M.T.
• Jeffery Deward Smith, PA

• Contractor in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Contractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; 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.