Individual provider Active NPI

Jonathan James Smith, PA-C

  • Medical Physician Assistant
  • Pauls Valley, OK
National Provider Identifier
1477823342
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2096 Issued in OK
Practice address
415 W Guy Ave
Pauls Valley, OK 73075-3200
Phone
(405) 238-1170
NPI assigned
Jan 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2096 OK Primary

Addresses

Primary practice location

415 W Guy Ave
Pauls Valley, OK 73075-3200

Mailing address

415 W Guy Ave
Pauls Valley, OK 73075-3200
Phone (405) 238-1170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130530000307 OK Practitioner - Physician Assistant 6002054236 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Classen Family Practice LLCGroup PAC ID 8729215025, 10 clinicians

Practice addresses (Care Compare)

2824 Classen Blvd
Norman, OK 73071-4059
Phone (405) 701-3563

Hospital & facility affiliations

  • Loving Care in-Home Health Services, L.L.C. Home health agency, Noble, OK, CCN 377604
  • Norman Regional Hospital, Norman, OK, CCN 370008
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Classen Urgent Care Clinic LLC CurrentSince Mar 18, 2013 Accepting new patients
Norman Regional Hospital Authority Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

1015 SW 4th St
Moore, OK 73160
Phone (405) 378-2001

2824 Classen Blvd
Norman, OK 73071
Phone (405) 701-3563

2818 Classen Blvd
Norman, OK 73071
Phone (405) 701-7111

2824 Classen Blvd
#100
Norman, OK 73071
Phone (405) 701-3563

Interoperability endpoints

  • Direct secure messaging: j.smith@cfp-ok.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326067200000",
    "number": "1477823342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W GUY AVE",
            "city": "PAULS VALLEY",
            "state": "OK",
            "postal_code": "730753200",
            "telephone_number": "405-238-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W GUY AVE",
            "city": "PAULS VALLEY",
            "state": "OK",
            "postal_code": "730753200",
            "telephone_number": "405-238-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JONATHAN",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-09",
        "last_updated": "2012-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "2096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pauls Valley, OK

Sources for this page

Verify at the official NPI Registry.