Jerold Robert Smith, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

26013660A Issued in IN

Practice address

551 E Jackson Blvd
Elkhart, IN 46516-3528

Phone

(574) 293-0040

Fax

(574) 389-8426

NPI assigned

Aug 18, 2019

Last updated

Aug 18, 2019By the provider in NPPES

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

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1566086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566086400000",
    "number": "1396391090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 E JACKSON BLVD",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465163528",
            "telephone_number": "574-293-0040",
            "fax_number": "574-389-8426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 E JACKSON BLVD",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465163528",
            "telephone_number": "574-293-0040",
            "fax_number": "574-389-8426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEROLD",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-18",
        "last_updated": "2019-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26013660A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenze Smead
• Anna Cornelia Smith, MSN, LMT, CN,
• Channel Smith
• David Smith
• Emma R Smith, MSW
• Judith Lynn Smith, PA-C
• Mary Smith
• Stephanie A. Smith, NP
• Krystal Smoot
• Michael Ellsworth Smothers, M.D.

• Pharmacist in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Pharmacist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.