Jack Arlyn Smith, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

0959 Issued in AK

Practice address

4001 Dale St
#201
Anchorage, AK 99508-5428

Phone

(907) 561-1185

NPI assigned

Feb 7, 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

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ear, Nose and Throat Specialists Alaska, Inc.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Anchorage, AK
  • NPI 1972552891
  NPD (past)
• Geneva Woods Ear, Nose and Throat Associates, Inc.

  • Otolaryngology Physician
  • Anchorage, AK
  • NPI 1114936499
  NPD (past)

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194797662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11060 BIRCH RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995161711",
            "telephone_number": "907-346-2839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 DALE ST",
            "address_2": "#201",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085428",
            "telephone_number": "907-561-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACK",
        "middle_name": "ARLYN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AK",
            "license": "0959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD0959",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward CR Smith, R.PH., M.S.
• Elizabeth Dawn Smith
• Felicity Janet Smith, CDM
• Hannah Smith
• Hollyn C Smith, CARE COORDINATOR
• Jennifer Catherine Smith, RN
• Julian David Smith, PA
• Katelyn Nicole Smith
• Kathryn Smith, RN
• Kaytlin Marie Smith

• Otolaryngology Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Otolaryngology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.