Jill Ann Smith, R.N.

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

5411624-3102 Issued in UT

Practice address

3732 Bari Way
B202
South Jordan, UT 84095-5590

Phone

(801) 691-8731

Fax

(801) 963-6945

NPI assigned

Apr 5, 2011

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1356630883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3732 BARI WAY",
            "address_2": "B202",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955590",
            "telephone_number": "801-691-8731",
            "fax_number": "801-963-6945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3732 BARI WAY",
            "address_2": "B202",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955590",
            "telephone_number": "801-691-8731",
            "fax_number": "801-963-6945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JILL",
        "middle_name": "ANN",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2011-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "UT",
            "license": "5411624-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Smith
• Brigham Ronald Smith, M.D.
• Courtney Cusick Smith
• Emily Ann Smith, ACMHC
• Evan Smith
• Kaylee Smith
• Marissa Smith, CSW
• McKenna Irene Smith, FNP-C, DNP, APRN
• Rylin Smith
• Steven D Smith, D.M.D.

• Administrator Registered Nurse in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Administrator Registered Nurse in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; 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.