Active NPI
Jatarra Smith
- Community Health Worker
- Satsuma, FL
National Provider Identifier
1063087989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 237001
- Practice address
- 100 Dalton CT
Satsuma, FL 32189-2400 - Phone
- (904) 258-4645
- NPI assigned
- May 24, 2021
- Last updated
- Jul 31, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 237001 | FL | Primary |
| In Home Supportive Care Agency | 253Z00000X | FL |
Addresses
Primary practice location
100 Dalton CT
Satsuma, FL 32189-2400
Mailing address
100 Dalton CT
Satsuma, FL 32189-2400
Phone (904) 258-4645
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 237001 | Other | FL | HOMEMAKER COMPANION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 237001 | FL | MD | Community Health Worker |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Phlebotomy Technician
- Satsuma, FL
- NPI 1831037449
-
- Home Health Agency
- Satsuma, FL
- NPI 1508554387
-
- Community Health Worker
- Satsuma, FL
- NPI 1255906939
-
- Home Health Aide
- Satsuma, FL
- NPI 1407588544
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690761600000",
"number": "1063087989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 DALTON CT",
"city": "SATSUMA",
"state": "FL",
"postal_code": "321892400",
"telephone_number": "904-258-4645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 DALTON CT",
"city": "SATSUMA",
"state": "FL",
"postal_code": "321892400",
"telephone_number": "904-258-4645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "JATARRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-24",
"last_updated": "2023-07-31",
"certification_date": "2023-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "FL",
"license": "237001",
"primary": true
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "FL",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HOMEMAKER COMPANION",
"identifier": "237001",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Satsuma, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.