Individual provider Active NPI

Jason G Smith, APRN

  • Certified Registered Nurse Anesthetist
  • Bridgeport, CT
National Provider Identifier
1366671026
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
071219 Issued in CT
Practice address
267 Grant St
Bridgeport, CT 06610-2805
Phone
(203) 384-3072
Fax
(203) 384-4619
NPI assigned
Jul 2, 2009
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 004146 CT
Certified Registered Nurse Anesthetist 367500000X 071219 CT Primary

Addresses

Primary practice location

267 Grant St
Bridgeport, CT 06610-2805

Mailing address

7365 Main St
Suite 310
Stratford, CT 06614-1300
Phone (203) 384-3072

Other practice location 1

256 Seaside Ave
Milford, CT 06460-4602
Phone (475) 882-6824

Other practice location 2

130 Division St
Derby, CT 06418-1326
Phone (203) 735-7421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
004146CTMDDental Hygienist
071219CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgeport Anesthesia Associates, P.C. Nurse Anesthetist, Certified Registered CurrentSince Oct 27, 2009 Accepting new patients
Stamford Anesthesiology Services, PC CurrentSince Jun 15, 2010 Accepting new patients
Integrated Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2011 Accepting new patients
Amsurg Stamford Anesthesia LLC CurrentSince Jun 4, 2018 Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

130 Division St
Derby, CT 06418
Phone (203) 732-1330

80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249

60 Wellington Rd
Milford, CT 06461
Phone (203) 878-2010

30 Waterchase Dr
Ste 2
Rocky Hill, CT 06067

2 Trap Falls Rd
Ste 414
Shelton, CT 06484
Phone (203) 282-4128

32 Strawberry Hill Ct
Stamford, CT 06902
Phone (203) 276-2000

778 Long Ridge Rd
Stamford, CT 06902
Phone (203) 322-2400

7365 Main St
Ste 310
Stratford, CT 06614
Phone (203) 384-3174

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1366671026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7365 MAIN ST",
            "address_2": "SUITE 310",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141300",
            "telephone_number": "203-384-3072",
            "fax_number": "203-384-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 GRANT ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102805",
            "telephone_number": "203-384-3072",
            "fax_number": "203-384-4619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "256 Seaside Ave",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "CT",
            "postal_code": "064604602",
            "country_code": "US",
            "telephone_number": "475-882-6824",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 Division St",
            "address_purpose": "LOCATION",
            "city": "Derby",
            "state": "CT",
            "postal_code": "064181326",
            "country_code": "US",
            "telephone_number": "203-735-7421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JASON",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "004146",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "071219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.