Jerry Alton Smith, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

018988 Issued in LA

Practice address

902 S Vienna St
Ruston, LA 71270-5830

Phone

(318) 513-1950

Fax

(318) 513-1952

NPI assigned

Jun 5, 2006

Last updated

Jul 31, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Jerry Alton Smith Professional name

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Family First Medicine, Apmc

  • Family Medicine Physician
  • Ruston, LA
  • NPI 1992868327
  Authorized official Same address or phone

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312070400000",
    "number": "1417996448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2034",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712732034",
            "telephone_number": "318-513-1950",
            "fax_number": "318-513-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 S VIENNA ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705830",
            "telephone_number": "318-513-1950",
            "fax_number": "318-513-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JERRY",
        "middle_name": "ALTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2011-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "018988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1691542",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERRY",
            "last_name": "SMITH",
            "middle_name": "ALTON",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Chantia Smith
• George B Smith, M.D.
• Gerald Wayne Smith, D.C.
• Glenda Marie Smith, LPN
• Gregory Wayne Smith, D.C.
• John Seth Smith, BCBA
• Kourtney Giles Smith, M.A., LPC, NBCC
• Landon Craig Smith, M.D.
• Melanie Smith
• Michelle H Smith, OT

• Family Medicine Physician in Ruston, LA
• Providers in Ruston, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.