Jessica Bryce Smith, A.A.S, P.S.S, C.H.W

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

195 W 12TH Ave
Eugene, OR 97401-3408

Phone

(541) 762-4325

Fax

(541) 684-4156

NPI assigned

Aug 8, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Associate of Applied Science

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511827200000",
    "number": "1457783722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "687 CHESHIRE AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974025060",
            "telephone_number": "541-343-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 W 12TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013408",
            "telephone_number": "541-762-4325",
            "fax_number": "541-684-4156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESSICA",
        "middle_name": "BRYCE",
        "name_prefix": "Ms.",
        "credential": "A.A.S, P.S.S, C.H.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2017-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50066493",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grant Andrew Smith, L.D.
• Holly Marie Smith
• Ian Smith
• Jacqueline Smith
• Jean Louise Smith, PHD
• Jill L Smith, MA
• Jonathan Roy Smith, CADC II
• Jordan Charles Smith, LMT
• Julia West Smith, LCSW
• Katharine E Smith

• Community Health Worker in Eugene, OR
• Providers in Eugene, OR by specialty
• Community Health Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; 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.