Jason Smith

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6742 Issued in AZ

Practice address

18561 N 59TH Ave Ste 117
Glendale, AZ 85308-1256

Phone

(623) 322-0654

Fax

(623) 322-0664

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1174633713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15681 N 29TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323726",
            "telephone_number": "602-932-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18561 N 59TH AVE STE 117",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081256",
            "telephone_number": "623-322-0654",
            "fax_number": "623-322-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "6742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "6742",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Freddie Smith
• Gary A Smith, DDS
• Geneva Gertrude Smith, A.C.N.P.
• Hannah Smith
• Jami Ann Smith
• Jason William Smith
• Jennifer M Smith, D.C
• Kenneth R Smith, D.O.
• Kristin N Smith, ANP
• Laura L. Smith, LPC, OTR/L

• Physical Therapist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.