Jacob Glen Smith, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

761 Issued in WY

Practice address

107 Commerce Dr
Suite a
Green River, WY 82935-6179

Phone

(307) 871-4411

NPI assigned

Feb 11, 2016

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

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Complete Chiropractics LLC

  • Chiropractor
  • Green River, WY
  • NPI 1376089581
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1255790788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 COMMERCE DR",
            "address_2": "SUITE A",
            "city": "GREEN RIVER",
            "state": "WY",
            "postal_code": "829356179",
            "telephone_number": "307-871-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 COMMERCE DR",
            "address_2": "SUITE A",
            "city": "GREEN RIVER",
            "state": "WY",
            "postal_code": "829356179",
            "telephone_number": "307-871-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACOB",
        "middle_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-11",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WY",
            "license": "761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shopko Stores Operating Co LLC
• Marti Jo Sidwell
• Sleep Better Wyoming LLC
• John Stephen Sloan, M.D.
• Gerry C Smith, OTR
• Smith'S Food and Drug Pharmacy #187
• Smiths Food & Drug Centers Inc
• Christi L Sprecher
• Karis Ann-Mychele Sprecher, CNA
• Kellie Sprecher

• Chiropractor in Green River, WY
• Providers in Green River, WY by specialty
• Chiropractor in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; 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.