Jeralyn S Smith, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

032054 Issued in GA

Practice address

133 W Athens St
Winder, GA 30680-1786

Phone

(770) 867-6633

Fax

(770) 867-6703

NPI assigned

Nov 9, 2005

Last updated

Aug 6, 2016By the provider in NPPES

Sex

Female

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

Medicare fee-for-service enrollment

Enrolled in GA

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeralyn.smith.1@9864.direct.athenahealth.com
• Direct secure messaging: jeralyn.smith@mgi.eclinicaldirectplus.com
• Direct secure messaging: jeralyn.smith1@gadirect.net

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.

• Medlink Georgia Inc

  • Federally Qualified Health Center (FQHC)
  • Colbert, GA
  • NPI 1396794541
  Medicare reassignment NPD
• Medlink Georgia, Inc

  dba MedLink Commerce Family Foot Clinic

  • Podiatric Clinic/Center
  • Commerce, GA
  • NPI 1619627460
  NPD
• Medlink Georgia Inc

  dba Medlink Colbert Building 2

  • Federally Qualified Health Center (FQHC)
  • Colbert, GA
  • NPI 1669951414
  NPD (past)

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470441600000",
    "number": "1437130135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "city": "COLBERT",
            "state": "GA",
            "postal_code": "306280459",
            "telephone_number": "706-788-3234",
            "fax_number": "706-788-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 W ATHENS ST",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306801786",
            "telephone_number": "770-867-6633",
            "fax_number": "770-867-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JERALYN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2016-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "032054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000726327F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derrick Eugene Sims, MD
• Deberah Lee Slade, LCSW
• Courtney M Slaughter, NP
• Smith Dental Care of Winder LLC
• Amy Smith
• John Christy Snyder, O.D.
• Darrell Allen Sorah Jr., OD
• Joseph C Souther, MD
• Southland Spine and Joint LLC (SouthPoint Ortho And Spine)
• Kyari Sowe

• Pediatrics Physician in Winder, GA
• Providers in Winder, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2016; 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.