Individual provider Active NPI

Jeremy Smith, MD

  • General Practice Physician
  • Owensboro, KY
National Provider Identifier
1396534111
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
01101462A Issued in IN
Practice address
3750 Ralph Ave Apt 126
Owensboro, KY 42303-2204
Phone
(812) 786-8821
NPI assigned
May 6, 2025
Last updated
Oct 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 01101462A IN Primary

Addresses

Primary practice location

3750 Ralph Ave Apt 126
Owensboro, KY 42303-2204

Mailing address

3750 Ralph Ave Apt 126
Owensboro, KY 42303-2204
Phone (812) 786-8821

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)
Not enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1746489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1396534111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 RALPH AVE APT 126",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423032204",
            "telephone_number": "812-786-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 RALPH AVE APT 126",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423032204",
            "telephone_number": "812-786-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-06",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01101462A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; 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.