Jeannine G Smith, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

811 Issued in MT

Practice address

126 E. Broadway St.
Suite #22
Missoula, MT 59802

Phone

(406) 543-9883

Fax

(406) 926-1722

NPI assigned

Oct 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Specialty

Chiropractic

Education

Cleveland Chiropractic College - Kansas City, 1996

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401667200000",
    "number": "1326129701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 E BROADWAY ST.",
            "address_2": "SUITE #22",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59802",
            "telephone_number": "406-543-9883",
            "fax_number": "406-926-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 E. BROADWAY ST.",
            "address_2": "SUITE #22",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59802",
            "telephone_number": "406-543-9883",
            "fax_number": "406-926-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEANNINE",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2014-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MT",
            "license": "811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0164084",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0164073",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "41321",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derek Gene Smith Jr., LMT
• Edith G Smith, PT
• Emily Beatrice Smith, MS, RD, LN
• George J. Walker Smith, LCPC MHP
• Gregory Allen Smith, M.D.
• Jennifer Kate Smith, LCSW, LAC
• Kyle Charles Smith, D.O.
• Leah Nicole Smith, MAT, ATC, CSCS
• Marianne Smith, LCPC
• Nicholas Smith, D.C

• Chiropractor in Missoula, MT
• Providers in Missoula, MT by specialty
• Chiropractor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; 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.