Jimmy J Smith, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

A5449 Issued in IA

Practice address

551 2ND St
Traer, IA 50675-1138

Phone

(319) 478-8515

Fax

(319) 478-8497

NPI assigned

Jan 9, 2007

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

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Traer Chiropractic 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Traer Chiropractic

  • Chiropractor
  • Traer, IA
  • NPI 1609229582
  Medicare reassignment Care Compare group NPD Authorized official
• Back in Motion Chiropractic LLC

  • Chiropractor
  • Waterloo, IA
  • NPI 1104287069
  NPD (past) Authorized official
• Wicks Chiropractic, P.C.

  • Chiropractor
  • Traer, IA
  • NPI 1679762389
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1164571451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 2ND ST",
            "city": "TRAER",
            "state": "IA",
            "postal_code": "506751138",
            "telephone_number": "319-478-8515",
            "fax_number": "319-478-8497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 2ND ST",
            "city": "TRAER",
            "state": "IA",
            "postal_code": "506751138",
            "telephone_number": "319-478-8515",
            "fax_number": "319-478-8497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JIMMY",
        "middle_name": "J",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A5449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "70908",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0070748",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164571451",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "252196",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BC BS",
            "identifier": "02918",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nudak Ventures LLC
• Trevor Parrish, DPT
• Peoples Community Health Clinic, Inc.
• Brian S. Rafferty, MD
• Redhawk Physical Therapy LLC
• Traer Chiropractic
• Traer Nursing Care Center, Inc.
• Traer Nursing Care Center, Inc.
• Matthew E Ulven, M.D.
• Wicks Chiropractic, P.C.

• All providers in Traer, IA
• Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.