Jonathan Tyler Smith, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

0101283882 Issued in VA

Practice address

4755 Pasture Rd BLDG 299
Fallon, NV 89496-5000

Phone

(775) 426-3128

NPI assigned

Apr 27, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1255913307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4755 PASTURE RD BLDG 299",
            "city": "FALLON",
            "state": "NV",
            "postal_code": "894965000",
            "telephone_number": "775-426-3128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 PASTURE RD BLDG 299",
            "city": "FALLON",
            "state": "NV",
            "postal_code": "894965000",
            "telephone_number": "775-426-3128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JONATHAN",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-27",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "VA",
            "license": "0101283882",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101283882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven David Sicherman, B.S.
• Nathan Silva, DPT
• Silver State Geriatrics LLC
• James P Smerdon, D.M.D.
• April Smith
• Lindsay Nichole Smith
• Melodee Joy Smith, MS OTR/L
• Mikayla L Smith
• Rachel Smith
• Savannah Smith

• General Practice Physician in Fallon, NV
• Providers in Fallon, NV by specialty
• General Practice Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.