Sally Jean Smith, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

C51395 Issued in CA

Practice address

2755 Loma Vista Rd
Ventura, CA 93003-1544

Phone

(805) 477-9922

Fax

(805) 477-9937

NPI assigned

Jan 24, 2007

Sex

Female

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sally.smith@632716043616260.direct.elationemr.com
• Direct secure messaging: ssmith3518386@oc.providencedirect.org
• Direct secure messaging: sallysmith@cfh.allscriptsdirect.net

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.

• Community Memorial Health System

  dba Community Memorial Hospital - Ventura

  • General Acute Care Hospital
  • Ventura, CA
  • NPI 1215903018
  Medicare reassignment NPD
• Dr. Sally Pediatrics

  • Pediatrics Physician
  • Ventura, CA
  • NPI 1558041590
  NPD Authorized official
• Community Memorial Health System

  dba Community Memorial Health Center

  • Multi-Specialty Clinic/Center
  • Ojai, CA
  • NPI 1588446892
  NPD
• Community Memorial Health System

  • Gynecologic Oncology Physician
  • Ventura, CA
  • NPI 1619453982
  NPD
• Harbor Family and Pediatric Medical

  dba Channel Islands Medical Group

  • Specialist
  • Ventura, CA
  • NPI 1679759286
  NPD (past)
• Keith a. Robertson, M.D. Apc

  • Orthopaedic Surgery Physician
  • Ventura, CA
  • NPI 1639387194
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1104971746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2755 LOMA VISTA RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031544",
            "telephone_number": "805-477-9922",
            "fax_number": "805-477-9937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 LOMA VISTA RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031544",
            "telephone_number": "805-477-9922",
            "fax_number": "805-477-9937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SALLY",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C51395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juliette Marie Smith
• Kathleen Smith
• Lillian Smith
• Mark Smith, M.D.
• Mary Smith
• Sandra M Smith
• Scott Ryan Smith, MD
• Bernard Alan Smyle, M.D.
• Kimberly Rose Snodgrass
• Matthew Snyder

• Pediatrics Physician in Ventura, CA
• Providers in Ventura, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.

Verify at the official NPI Registry.