Jermain M Smith, BEHAVIOR ANALYST

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-21-49303

Practice address

300 W Swanson Ave
Wasilla, AK 99654-6844

Phone

(907) 357-0891

NPI assigned

Oct 13, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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": "1539388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1073088308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2088 S PADDOCK DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548467",
            "telephone_number": "907-203-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W SWANSON AVE",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546844",
            "telephone_number": "907-357-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JERMAIN",
        "middle_name": "M",
        "credential": "BEHAVIOR ANALYST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-13",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": "RBT-18-67793",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-21-49303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Smith
• Donald Edward Smith, PA-C
• Douglas Edward Smith, BS
• Elowyn M Smith, DO
• Haley Smith
• Jesse Gerald Smith III
• Joseph Smith
• Kimberley Ann Smith
• Louis Michael Smith, PA-C
• Michelle Smith, PHARMD

• Behavior Analyst in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Behavior Analyst in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; 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.