Jordan Smith

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

82812-20 Issued in WI

Practice address

11040 N State Rd 77
Hayward, WI 54843

Phone

(715) 934-4910

Fax

(316) 665-6082

NPI assigned

Jun 25, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Sports Medicine

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Services, IncGroup PAC ID 9436061363, 32 clinicians

Advantage Physical Therapy and Sports Rehab, LLCGroup PAC ID 8022016336, shared by 3 NPIs, 289 clinicians

Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Regional Hospice Services Hospice, Ashland, WI, CCN 521539
• Tamarack Health Hayward Medical Center Hospital, Hayward, WI, CCN 521336
• Hayward Health Services Nursing home, Hayward, WI, CCN 525434

Merit-based Incentive Payment System (MIPS)

Final score

93.05 of 100Reported as group

Quality

87.37

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Medical Services, Inc

  • Critical Access Hospital
  • Hayward, WI
  • NPI 1912992827
  Medicare reassignment Care Compare group NPD
• Polinsky Medical Rehabilitation Center

  • Rehabilitation Clinic/Center
  • Duluth, MN
  • NPI 1639237746
  Care Compare group
• Medical Services, Inc

  • Rural Health Clinic/Center
  • Hayward, WI
  • NPI 1386316537
  NPD
• Medical Services, Inc

  • Skilled Nursing Facility
  • Hayward, WI
  • NPI 1902810450
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Medical Services, Inc

  • Critical Access Hospital
  • Hayward, WI
  • NPI 1912992827
  Care Compare affiliation
• NSH Valley of Hayward LLC

  • Skilled Nursing Facility
  • Hayward, WI
  • NPI 1134661853

  Nursing home

  Care Compare affiliation
• Regional Hospice Services,Inc.

  • Community Based Hospice Care Agency
  • Ashland, WI
  • NPI 1184627499
  Care Compare affiliation

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1346866357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11040 N STATE RD 77",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "54843",
            "telephone_number": "715-934-4910",
            "fax_number": "316-665-6082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11040 N STATE RD 77",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "54843",
            "telephone_number": "715-934-4910",
            "fax_number": "316-665-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-25",
        "last_updated": "2024-09-11",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WI",
            "license": "82812-20",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "82812-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Skar
• Kathleen M Skoraczewski, MS
• Sarah Christine Sloan, M.A. CCC/SLP
• Cynthia M Smith
• Desiree Ann Smith, PMHNP-BC
• Suzanne Michelle Smith, RN
• Lori Leanne Soli, PHD LPCC ACS BCTMH
• Solid Ground Counseling LLC
• Debbra Lee Spexet, APRN, CNP
• Ashli Srmek, FNP

• Family Medicine Physician in Hayward, WI
• Providers in Hayward, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.