Individual provider Active NPI

Jonna Smith

  • Marriage & Family Therapist
  • Truth Or Consequences, NM
National Provider Identifier
1619445822
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T-CTL0197631 Issued in NM
Practice address
312 N Broadway St
Truth Or Consequences, NM 87901-2834
Phone
(575) 740-0719
NPI assigned
Nov 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X T-CTL0197631 NM Primary

Addresses

Primary practice location

312 N Broadway St
Truth Or Consequences, NM 87901-2834

Mailing address

PO Box 125
Caballo, NM 87931-0125
Phone (575) 740-0719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20241104003567 NM Practitioner - Marriage and Family Therapist 1759814312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

312 N Broadway St
Truth Or Consequences, NM 87901-2834
Phone (575) 740-0719

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T-CTL0197631NMMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Movers Family Therapy, PC Marriage & Family Therapist CurrentSince Oct 1, 2024 Accepting new patients

Locations

312 N Broadway St
Truth Or Consequences, NM 87901
Phone (575) 297-0157

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1619445822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 125",
            "city": "CABALLO",
            "state": "NM",
            "postal_code": "879310125",
            "telephone_number": "575-740-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 N BROADWAY ST",
            "city": "TRUTH OR CONSEQUENCES",
            "state": "NM",
            "postal_code": "879012834",
            "telephone_number": "575-740-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JONNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-06",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NM",
            "license": "T-CTL0197631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Truth Or Consequences, NM

Sources for this page

Verify at the official NPI Registry.