Jessica Lorelle Smith

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-19-39989 Issued in NC

Practice address

130 Charlois Blvd
Winston Salem, NC 27103-1522

Phone

(336) 777-7239

Fax

(317) 520-8200

NPI assigned

May 21, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Lorelle Juett Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Hopebridge LLC

  • Occupational Therapist
  • Greeley, CO
  • NPI 1174193965
  NPD (past)

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1649761107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BLVD STE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135",
            "telephone_number": "855-324-0885",
            "fax_number": "317-520-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CHARLOIS BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031522",
            "telephone_number": "336-777-7239",
            "fax_number": "317-520-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 E 7th St",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282046300",
            "country_code": "US",
            "telephone_number": "704-780-4271",
            "fax_number": "888-261-6694",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3851 Dunhagan Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278586640",
            "country_code": "US",
            "telephone_number": "252-751-0518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESSICA",
        "middle_name": "LORELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-21",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "1-19-39989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "JUETT",
            "middle_name": "LORELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeffrey Alan Smith, PH.D.
• Jenie Smith
• Jennifer Lynn Smith, PA-C
• Jennifer M Smith, NP
• Jennifer Rose Smith
• Jessica Marie Smith, PHARMD, CPP
• John Baldwin Smith III
• John Joseph Smith III, MD
• Katlyn E Smith
• Kayla Hauss Smith, DO

• Behavior Analyst in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Behavior Analyst in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; 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.