Jesse Smotherman, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

1577PL Issued in LA

Practice address

120 Village St Ste 2
Slidell, LA 70458-5300

Phone

(888) 606-0086

Fax

(346) 223-0296

NPI assigned

Apr 28, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Neurocognitive Specialty Group, PLLC

  • Clinical Neuropsychologist
  • League City, TX
  • NPI 1346700275
  NPD

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1497338453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 STRATFORD DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704581745",
            "telephone_number": "985-285-9473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 VILLAGE ST STE 2",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704585300",
            "telephone_number": "888-606-0086",
            "fax_number": "346-223-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOTHERMAN",
        "first_name": "JESSE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-28",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "LA",
            "license": "1577PL",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "LA",
            "license": "1577PL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morchell Smith, LCSW
• Rachele Smith
• Sumathi Siva Smith, M.D.
• Tessa M Smith, DDS
• Smooth Transportation LLC
• Dwana R Smothers
• Luis W. Socarras, LPC,MAMFC
• Holly Lorraine Solnick, N.P.
• Solomon North Homecare LLC
• Brooke Nicole Somerville, LMT

• Clinical Neuropsychologist in Slidell, LA
• Providers in Slidell, LA by specialty
• Clinical Neuropsychologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; 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.