Organization Active NPI

Jeffrey T. Smith, PH.D., P.a.

  • Clinical Psychologist
  • St Petersburg, FL
National Provider Identifier
1477854156
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY4531 Issued in FL
Legal business name
JEFFREY T. SMITH, PH.D., P.A.
Practice address
1905 Tyrone Blvd N
St Petersburg, FL 33710-4841
Phone
(727) 347-3284
Fax
(727) 347-4472
NPI assigned
Nov 10, 2010
Last updated
Nov 10, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Authorized official

Name
Dr. Jeffrey Thornton Smith, PH.D.
Title
President
Phone
(727) 347-3284

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY4531 FL Primary

Addresses

Primary practice location

1905 Tyrone Blvd N
St Petersburg, FL 33710-4841

Mailing address

1905 Tyrone Blvd N
St Petersburg, FL 33710-4841
Phone (727) 347-3284

National Provider Directory

National Provider Directory

Locations

1905 Tyrone Blvd N
St Petersburg, FL 33710
Phone (727) 308-1330

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289347200000",
    "number": "1477854156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 TYRONE BLVD N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337104841",
            "telephone_number": "727-347-3284",
            "fax_number": "727-347-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 TYRONE BLVD N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337104841",
            "telephone_number": "727-347-3284",
            "fax_number": "727-347-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY T. SMITH, PH.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-10",
        "last_updated": "2010-11-10",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "THORNTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-347-3284",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY4531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; 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.