Jacqueline J Smith

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

339740 Issued in NY

Practice address

592 Shepherd Ave
Brooklyn, NY 11208-3600

Phone

(718) 825-6212

Fax

(718) 978-0032

NPI assigned

Sep 22, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1695340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1356120083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "592 SHEPHERD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112083600",
            "telephone_number": "718-825-6212",
            "fax_number": "718-978-0032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "592 SHEPHERD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112083600",
            "telephone_number": "718-825-6212",
            "fax_number": "718-978-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACQUELINE",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-22",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "339740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guillermo Alfredo Smith
• Halle Smith, PA-C
• Hamilton Elijah Smith, APRN
• Henry Smith, MSW, RCPA
• Imani Smith
• Jaimie Smith, MSOTR/L
• James Kenneth Smith, M.D
• James Richard Smith
• Jamil Rondrick Smith, L.AC
• Jamila Smith, LMSW

• Licensed Practical Nurse in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; 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.