Individual provider Active NPI

Jason A Smith, D.C.

  • Chiropractor
  • Saint Paul, MN
National Provider Identifier
1215019922
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3356 Issued in MN
Practice address
1820 Rice St
Saint Paul, MN 55113-6810
Phone
(651) 489-6550
Fax
(651) 489-6556
NPI assigned
Oct 20, 2006
Last updated
Jan 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3356 MN Primary
Acupuncturist 171100000X 525 MN

Addresses

Primary practice location

1820 Rice St
Saint Paul, MN 55113-6810

Mailing address

1820 Rice St
Saint Paul, MN 55113-6810
Phone (651) 489-6550

Other identifiers 2

IdentifierTypeStateIssuer
553S1SMOtherMNBCBS
590716100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050502000124 MN Practitioner - Chiropractic 4880633650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jason a Smith DC PAGroup PAC ID 4981643756, 3 clinicians

Practice addresses (Care Compare)

1820 Rice St
Saint Paul, MN 55113-6810
Phone (651) 489-6550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3356MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jason a Smith DC PA Chiropractor CurrentSince Jun 3, 2003 Accepting new patients
MLC Too LLC Chiropractor Current Accepting new patients
Dettling Chiropractic Rehab and Performance PLLC Chiropractor Past Accepting new patients
MJ Chiropractic Chiropractor Past Accepting new patients

Locations

1700 Rice St
Ste B
Saint Paul, MN 55113
Phone (651) 489-5440

1820 Rice St
Saint Paul, MN 55113
Phone (651) 489-6550

Organizations & group practices 4

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1215019922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 RICE ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551136810",
            "telephone_number": "651-489-6550",
            "fax_number": "651-489-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 RICE ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551136810",
            "telephone_number": "651-489-6550",
            "fax_number": "651-489-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JASON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3356",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "525",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "553S1SM",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "590716100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; 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.