Dwight Smith Jr.

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

2525 Conklin Dr Apt 22
Rockford, IL 61101-1871

Phone

(779) 210-1136

NPI assigned

Nov 10, 2019

Sex

Male

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": "1573344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573344000000",
    "number": "1366087660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 CONKLIN DR APT 22",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611011871",
            "telephone_number": "847-306-9843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CONKLIN DR APT 22",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611011871",
            "telephone_number": "779-210-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DWIGHT",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-10",
        "last_updated": "2019-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brena Marie Smith, D.C.
• Cameron Joseph Smith, PHARMD
• Chandra Nicole Smith, FNP-C
• Chelsea Smith, FNP-BC
• Colleena Sue Smith
• Erik John Smith
• Jeffrey R Smith, MD
• Jill Frances Smith
• Katera Smith
• Katherine Smith, M.A. CCC-SLP

• Behavior Analyst in Rockford, IL
• Providers in Rockford, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2019; 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.