Individual provider Active NPI

Johnny Lee Smith, RRT

  • Registered Respiratory Therapist
  • Jackson, MS
National Provider Identifier
1629310560
Registry record updated Mar 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Respiratory TherapistTaxonomy code 227900000X
License
RCP1286 Issued in MS
Practice address
1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116
Phone
(601) 362-4471
Fax
(601) 364-1222
NPI assigned
Mar 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Respiratory Therapist 227900000X RCP1286 MS Primary
Critical Care Registered Respiratory Therapist 2279C0205X RCP1286 MS

Addresses

Primary practice location

1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116

Mailing address

1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116
Phone (601) 362-4471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RCP1286MSMDCritical Care Registered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363564800000",
    "number": "1629310560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165116",
            "telephone_number": "601-362-4471",
            "fax_number": "601-364-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165116",
            "telephone_number": "601-362-4471",
            "fax_number": "601-364-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOHNNY",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "RRT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-18",
        "last_updated": "2013-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "227900000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered",
            "state": "MS",
            "license": "RCP1286",
            "primary": true
        },
        {
            "code": "2279C0205X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Critical Care",
            "state": "MS",
            "license": "RCP1286",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2013; 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.