Jobril Marquez Smith

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1955 W Broadway
Monona, WI 53713-3700

Phone

(608) 285-9101

NPI assigned

Aug 21, 2018

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1104306828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 N THOMPSON DR APT 1",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537141737",
            "telephone_number": "901-600-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 W BROADWAY",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537133700",
            "telephone_number": "608-285-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOBRIL",
        "middle_name": "MARQUEZ",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shoptikal LLC
• Virgil Merle Simley, D.D.S.
• Ruby June Sisler
• Amber Slabaugh, MSW, LCSW
• Pageen Manolis Small, RN
• John Andrew Smith, LPC, CASC, ICS
• Patricia Smith, OTR
• Joanne Lin Snow, MD
• Julie E Snyder
• Beverly J Speece, PA-C

• All providers in Monona, WI
• Case Manager/Care Coordinator in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.