NPIMap

Individual provider Active NPI

Jennifer Emily Smith, M.D.

  • Family Medicine Physician
  • Gig Harbor, WA
National Provider Identifier
1215919170
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00039281 Issued in WA
Practice address
4700 Point Fosdick Dr Ste 220
Gig Harbor, WA 98335-1706
Phone
(253) 851-5121
NPI assigned
Nov 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00039281 WA Primary

Addresses

Primary practice location

4700 Point Fosdick Dr Ste 220
Gig Harbor, WA 98335-1706

Mailing address

4700 Point Fosdick Dr Ste 220
Gig Harbor, WA 98335-1706
Phone (253) 851-5121

Other identifiers 1

IdentifierTypeStateIssuer
8281271MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101116001041 WA Practitioner - Family Practice 5496940488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Peninsula Family Medical CenterGroup PAC ID 2961399266, 10 clinicians

Practice addresses (Care Compare)

4700 Point Fosdick Dr
Suite 220
Gig Harbor, WA 98335-1706
Phone (253) 851-5121

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Tacoma, WA, CCN 507031
  • Signature Healthcare at Home Home health agency, Federal Way, WA, CCN 507110
  • CHI Franciscan Health at Home Home health agency, University Place, WA, CCN 507124
  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions16
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00039281WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Family Medical Center Family Medicine CurrentSince Aug 20, 2001 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 220
Gig Harbor, WA 98335
Phone (253) 851-5121

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 and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1215919170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 POINT FOSDICK DR STE 220",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351706",
            "telephone_number": "253-851-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 POINT FOSDICK DR STE 220",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351706",
            "telephone_number": "253-851-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "middle_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00039281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8281271",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

Verify at the official NPI Registry.