Individual provider Active NPI

Jonathan Smith Jr., PA-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1194321992
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10248 Issued in GA
Practice address
95 Collier Rd NW Ste 5015
Atlanta, GA 30309-1721
Phone
(404) 605-6517
NPI assigned
Dec 7, 2020
Last updated
Feb 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 10248 GA
Physician Assistant 363A00000X 10248 GA Primary

Addresses

Primary practice location

95 Collier Rd NW Ste 5015
Atlanta, GA 30309-1721

Mailing address

95 Collier Rd NW Ste 5015
Atlanta, GA 30309-1721

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Jonathan.Smith@piedmont.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210622001303 GA Practitioner - Physician Assistant 5890196315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10248GAMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: jonathan.smith@piedmont.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1194321992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 COLLIER RD NW STE 5015",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 COLLIER RD NW STE 5015",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091721",
            "telephone_number": "404-605-6517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JONATHAN",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-07",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "10248",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jonathan.Smith@piedmont.org",
            "affiliation": "N",
            "address_1": "95 Collier Rd NW",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303091796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.