Judy Lynn Smith, MD

Primary specialty

Surgical Oncology PhysicianTaxonomy code 2086X0206X

License

4301104264 Issued in MI

Practice address

145 Michigan St NE
Suite 5500
Grand Rapids, MI 49503-2562

Phone

(616) 267-8540

Fax

(616) 458-6230

NPI assigned

Nov 8, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387152000000",
    "number": "1154302172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 MICHIGAN ST NE",
            "address_2": "SUITE 5500",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032562",
            "telephone_number": "616-267-8540",
            "fax_number": "616-458-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JUDY",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2013-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "177741-1",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "MI",
            "license": "4301104264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LICENSE",
            "identifier": "4301104264",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1154302172",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Smith, M.D.
• Jessica Eunice Smith, LMSW, CAADC
• Joanne Smith
• Jordan Nathaniel Smith, LLMFT
• Joshua Ryan Smith, M.D.
• Julia Smith
• Julia Smith
• Julie Smith
• Julie Lynn Smith, LMSW
• Justice Gabrielle Smith

• Surgical Oncology Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Surgical Oncology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2013; 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.