Judson D. Smith, ED.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS352 Issued in ME

Practice address

62 Elm St
Portland, ME 04101-3091

Phone

(207) 553-7056

Fax

(207) 773-2082

NPI assigned

Jan 25, 2006

Last updated

Oct 3, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191369600000",
    "number": "1518937242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 FRANKLIN ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014909",
            "telephone_number": "207-942-3816",
            "fax_number": "207-561-4725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 ELM ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013091",
            "telephone_number": "207-553-7056",
            "fax_number": "207-773-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JUDSON",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2007-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ME",
            "license": "PS352",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS352",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM LEGACY NUMBER",
            "identifier": "098303",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasmine R Smith, LCPCC
• Jensen Scott Smith
• Jesse Smith
• Jill Anne Smith, LMT
• Jordan M Smith, LMSW-CC
• Julia Keeler Smith, DO
• Katherine Smith
• Lynn Smith, PT
• Lyntavia Smith, LMSW
• Meaghan Catherine Smith, REGISTERED NURSE

• Psychologist in Portland, ME
• Providers in Portland, ME by specialty
• Psychologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.