Active NPI
Jeremy Todd Smith, D.O.
- Emergency Medicine Physician
- Tulsa, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- PENDING
- Practice address
- 717 W 71St St
Tulsa, OK 74132-1824 - Phone
- (918) 517-6300
- NPI assigned
- May 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 4812 | OK | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | PENDING | MS | Primary |
Addresses
Primary practice location
717 W 71St St
Tulsa, OK 74132-1824
Mailing address
717 W 71St St
Tulsa, OK 74132-1824
Phone (918) 517-6300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK, MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4812 | OK | MD | Clinical Social Worker |
| PENDING | MS | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Services of Oklahoma PC | Emergency Medicine | Current | Accepting new patients |
| St. John Physicians, Inc | Current | Accepting new patients | |
| Keystone Medical Services of Ms, Inc | Emergency Medicine | Current | Accepting new patients |
| Oklahoma Emergency Physician Partners PLLC | Emergency Medicine | Current | Accepting new patients |
| Attala Emergency Group LLC | Emergency Medicine | Current | Accepting new patients |
| St. John Physicians, Inc. | Emergency Medicine | Current | Accepting new patients |
Locations
1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303
220 Highway 12 W
Kosciusko, MS 39090
Phone (662) 289-4311
1800 W University Blvd
Durant, OK 74701
Phone (580) 924-3080
4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200
1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660
1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345
1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Norman, OK
- NPI 1215249891
-
- Emergency Medicine Physician
- Kosciusko, MS
- NPI 1407103294
-
- Emergency Medicine Physician
- Hazlehurst, MS
- NPI 1174691059
-
- Emergency Medicine Physician
- Durant, OK
- NPI 1891039764
-
- Rural Health Clinic/Center
- Barnsdall, OK
- NPI 1033176367
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657584000000",
"number": "1104047331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "717 W 71ST ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741321824",
"telephone_number": "918-517-6300",
"fax_number": "918-517-6309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "717 W 71ST ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741321824",
"telephone_number": "918-517-6300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "JEREMY",
"middle_name": "TODD",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-02",
"last_updated": "2022-07-12",
"certification_date": "2022-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OK",
"license": "4812",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MS",
"license": "PENDING",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.