Jerren Smith, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0070016382 Issued in IL

Practice address

18352 May St
Homewood, IL 60430-3546

Phone

(708) 768-4413

NPI assigned

Jun 5, 2009

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)

Enrolled

State licenses

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244160000000",
    "number": "1053547984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18352 MAY ST",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604303546",
            "telephone_number": "708-768-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18352 MAY ST",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604303546",
            "telephone_number": "708-768-4413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JERREN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-05",
        "last_updated": "2009-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "0070016382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miyanna Smith-Stamps
• Antoinette Smith
• Arielle Elyce Smith, DSW, LCSW
• Jalyn Antoinette Smith
• Jan L Smith, MA
• Layla Smith
• Lori Anne Smith
• Marisha Smith, LPC
• Santana Smith
• Tarik N Smith

• Physical Therapist in Homewood, IL
• Providers in Homewood, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2009; 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.