Jeremy Smith MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M0573 Issued in TX

Legal business name

JEREMY SMITH MD PA

Practice address

1320 N University Dr
Nacogdoches, TX 75961-4269

Phone

(936) 559-9225

Fax

(936) 559-7911

NPI assigned

Mar 22, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Jeremy Scott Smith, MD

Title

Owner

Phone

(936) 645-6008

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414454400000",
    "number": "1336463264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 N UNIVERSITY DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614269",
            "telephone_number": "936-559-9225",
            "fax_number": "936-559-7911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 N UNIVERSITY DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614269",
            "telephone_number": "936-559-9225",
            "fax_number": "936-559-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMY SMITH MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-22",
        "last_updated": "2014-10-28",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-645-6008",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M0573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; 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.