Organization Active NPI

Jason a Smith DC PA

  • Chiropractor
  • Saint Paul, MN
National Provider Identifier
1336344738
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3356 Issued in MN
Legal business name
JASON A SMITH DC PA
Practice address
1820 Rice St
Saint Paul, MN 55113-6810
Phone
(651) 489-6550
Fax
(651) 489-6556
NPI assigned
Jun 18, 2007
Last updated
Feb 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Authorized official

Name
Jason A Smith, DCNPI 1215019922
Title
Cfo
Phone
(651) 489-6550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 3356 MN Primary

Addresses

Primary practice location

1820 Rice St
Saint Paul, MN 55113-6810

Mailing address

1820 Rice St
Saint Paul, MN 55113-6810
Phone (651) 489-6550

Other identifiers 1

IdentifierTypeStateIssuer
590716100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050502000090 MN Part B Supplier - Clinic/Group Practice 4981643756 Receives reassigned benefits from 4 practitioners
Practice locations: Saint Paul, MN

National Provider Directory

National Provider Directory

Locations

1700 Rice St
Ste B
Saint Paul, MN 55113
Phone (651) 489-5440

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1336344738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 RICE ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551136810",
            "telephone_number": "651-489-6550",
            "fax_number": "651-489-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 RICE ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551136810",
            "telephone_number": "651-489-6550",
            "fax_number": "651-489-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON A SMITH DC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "651-489-6550",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "590716100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.