Individual provider Active NPI

Jill N Smith, RT,LRT,M

  • Radiologic Technologist
  • Canandaigua, NY
National Provider Identifier
1285891291
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiologic TechnologistTaxonomy code 247100000X
License
790856 Issued in NY
Practice address
2926 County Road 47
Canandaigua, NY 14424-8832
Phone
(585) 905-0698
NPI assigned
May 19, 2008
Last updated
May 19, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiologic Technologist 247100000X 790856 NY Primary

Addresses

Primary practice location

2926 County Road 47
Canandaigua, NY 14424-8832

Mailing address

2926 County Road 47
Canandaigua, NY 14424-8832
Phone (585) 905-0698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
790856NYMDRadiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1285891291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2926 COUNTY ROAD 47",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144248832",
            "telephone_number": "585-905-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2926 COUNTY ROAD 47",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144248832",
            "telephone_number": "585-905-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JILL",
        "middle_name": "N",
        "credential": "RT,LRT,M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "NY",
            "license": "790856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.