Individual provider Active NPI

Jaclyn M Smith, MD

  • Hospitalist Physician
  • Danville, IN
National Provider Identifier
1558588202
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
01063523A Issued in IN
Practice address
1000 E Main St
Danville, IN 46122-1948
Phone
(317) 745-4451
Fax
(317) 718-6740
NPI assigned
Apr 20, 2007
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 013063523A IN
Hospitalist Physician 208M00000X 01063523A IN Primary

Addresses

Primary practice location

1000 E Main St
Danville, IN 46122-1948

Mailing address

1000 E Main St
Danville, IN 46122-1948
Phone (317) 745-4451

Other identifiers 3

IdentifierTypeStateIssuer
000000911432OtherINANTHEM PROVIDER NUMBER - ARNETT CLINIC, LLC
000000550465OtherINANTHEM
200868320MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jsmith329316@direct-PRD.stelizabeth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080813000545 IN Practitioner - Internal Medicine 4385719103 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Indiana University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hendricks County HospitalGroup PAC ID 4880505528, 341 clinicians

Practice addresses (Care Compare)

1000 E Main St
Danville, IN 46122-1948

8244 E US Hwy 36
Avon, IN 46123-9688

8244 E US Hwy 36 1100
Hendricks Community Hospital
Avon, IN 46123-9627
Phone (317) 272-7500

8244 E US Hwy 36 1320
Avon Internal Medicine
Avon, IN 46123-9688
Phone (317) 272-7519

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
013063523AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arnett Clinic, LLC Internal Medicine CurrentSince Jan 15, 2015 Accepting new patients
Hendricks County Hospital Hospitalist CurrentSince Jul 25, 2020 Accepting new patients
Hendricks County Hospital Current Accepting new patients
Hendricks County Hospital CurrentSince Jul 25, 2020 Accepting new patients
Arnett Clinic, LLC CurrentSince Jan 15, 2015 Accepting new patients
Arnett Clinic, LLC Current Accepting new patients
Hamiltion Inpatient Physicians, LLC CurrentSince Jul 1, 2008 Accepting new patients
Hendricks County Hospital Past Accepting new patients
Hendricks County Hospital Past Accepting new patients

Locations

8016 Reliable Pkwy
Chicago, IL 60686

8244 E US Highway 36
Ste 1100
Avon, IN 46123
Phone (317) 272-7500

8244 E US Highway 36
Ste 1340
Avon, IN 46123
Phone (317) 520-5510

1000 E Main St
Danville, IN 46122
Phone (317) 745-3420

255 Meadow Dr
Danville, IN 46122
Phone (317) 745-5451

2600 Ferry St
Lafayette, IN 47904

2600 Greenbush St
Lafayette, IN 47904

1200 W White River Blvd
Muncie, IN 47303
Phone (765) 254-4009

176 W Logan St
Noblesville, IN 46060

395 Westfield Rd
Noblesville, IN 46060
Phone (317) 218-3136

Interoperability endpoints

  • FHIR API: https://sehproxy.stelizabeth.com/arr-fhir/api/FHIR/R4
  • Direct secure messaging: jsmith329316@direct-prd.stelizabeth.com

Organizations & group practices 9

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

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": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1558588202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E MAIN ST",
            "city": "DANVILLE",
            "state": "IN",
            "postal_code": "461221948",
            "telephone_number": "317-745-4451",
            "fax_number": "317-718-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E MAIN ST",
            "city": "DANVILLE",
            "state": "IN",
            "postal_code": "461221948",
            "telephone_number": "317-745-4451",
            "fax_number": "317-718-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACLYN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "013063523A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01063523A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER - ARNETT CLINIC, LLC",
            "identifier": "000000911432",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000550465",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200868320",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsmith329316@direct-PRD.stelizabeth.com",
            "affiliation": "N",
            "address_1": "1000 E Main St",
            "city": "Danville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461221948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, IN

Sources for this page

Verify at the official NPI Registry.