Individual provider Active NPI

Jillian Marie Smith, AU.D.

  • Audiologist
  • Valparaiso, IN
National Provider Identifier
1174959068
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
2802 Leonard Dr
Valparaiso, IN 46383-7136
Phone
(219) 531-0625
NPI assigned
Sep 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X Primary

Addresses

Primary practice location

2802 Leonard Dr
Valparaiso, IN 46383-7136

Mailing address

2022 Beech St
Apt 204
Valparaiso, IN 46383-5990
Phone (317) 709-5828

Other names 1

  • Dr. Jillian Marie Simison Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1174959068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 BEECH ST",
            "address_2": "APT 204",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463835990",
            "telephone_number": "317-709-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 LEONARD DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463837136",
            "telephone_number": "219-531-0625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JILLIAN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-24",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "SIMISON",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "AU.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; 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.