Individual provider Active NPI

Jennifer Elizabeth Smith

  • School Psychologist
  • Staunton, VA
National Provider Identifier
1629761754
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
3001024603 Issued in WI
Practice address
1751 Shutterlee Mill Rd
Staunton, VA 24401-1709
Phone
(540) 332-3934
NPI assigned
Jun 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 3001024603 WI Primary

Addresses

Primary practice location

1751 Shutterlee Mill Rd
Staunton, VA 24401-1709

Mailing address

4 Brandon Ladd Cir
Waynesboro, VA 22980-3221
Phone (262) 951-5286

Other practice location 1

1101 N Coalter St
Staunton, VA 24401-2506
Phone (540) 332-3936

Other practice location 2

1301 N Coalter St
Staunton, VA 24401-2537
Phone (540) 332-3926

Other practice location 3

300 Grubert Ave
Staunton, VA 24401-2947
Phone (540) 332-3930

Other practice location 4

330 Grubert Ave
Staunton, VA 24401-2947
Phone (540) 332-3938

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
3001024603WIMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1629761754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BRANDON LADD CIR",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229803221",
            "telephone_number": "262-951-5286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 SHUTTERLEE MILL RD",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244011709",
            "telephone_number": "540-332-3934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 N Coalter St",
            "address_purpose": "LOCATION",
            "city": "Staunton",
            "state": "VA",
            "postal_code": "244012506",
            "country_code": "US",
            "telephone_number": "540-332-3936",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1301 N Coalter St",
            "address_purpose": "LOCATION",
            "city": "Staunton",
            "state": "VA",
            "postal_code": "244012537",
            "country_code": "US",
            "telephone_number": "540-332-3926",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Grubert Ave",
            "address_purpose": "LOCATION",
            "city": "Staunton",
            "state": "VA",
            "postal_code": "244012947",
            "country_code": "US",
            "telephone_number": "540-332-3930",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 Grubert Ave",
            "address_purpose": "LOCATION",
            "city": "Staunton",
            "state": "VA",
            "postal_code": "244012947",
            "country_code": "US",
            "telephone_number": "540-332-3938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "WI",
            "license": "3001024603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staunton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; 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.