Individual provider Active NPI

Jeffrey Glenn Smith, DC

  • Chiropractor
  • Dallas, TX
National Provider Identifier
1063404275
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC6013 Issued in TX
Practice address
9850 N Central Expy
Ste. 260
Dallas, TX 75231-0963
Phone
(214) 956-0999
Fax
(214) 956-0990
NPI assigned
Aug 16, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC6013 TX Primary

Addresses

Primary practice location

9850 N Central Expy
Ste. 260
Dallas, TX 75231-0963

Mailing address

9850 N Central Expy
Ste. 260
Dallas, TX 75231-0963
Phone (214) 956-0999

Other identifiers 1

IdentifierTypeStateIssuer
603912OtherTXBCBS

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC6013TXMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063404275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9850 N CENTRAL EXPY",
            "address_2": "STE. 260",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752310963",
            "telephone_number": "214-956-0999",
            "fax_number": "214-956-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 N CENTRAL EXPY",
            "address_2": "STE. 260",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752310963",
            "telephone_number": "214-956-0999",
            "fax_number": "214-956-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEFFREY",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "DC6013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "603912",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.