Jack Steven Smith, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

684 Issued in AZ

Practice address

1815 W Missouri Ave Ste 102
Phoenix, AZ 85015-3047

Phone

(623) 398-9213

NPI assigned

Nov 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. J S Smith Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446076800000",
    "number": "1659450773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 W MISSOURI AVE STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850153047",
            "telephone_number": "623-398-9213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 W MISSOURI AVE STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850153047",
            "telephone_number": "623-398-9213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACK",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2015-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "684",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "AZ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J",
            "last_name": "SMITH",
            "middle_name": "S",
            "prefix": "DR.",
            "credential": "DC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Gregory T Smith, D.D.S.
• Gwenneth P. Smith, P.T.
• Gwyndolen Smith, LPN
• Harriet J Smith, PHD
• Herman Bradley Smith, MD
• Jade Smith, OTD, OTR/L
• Jala Latrice Nicole Smith
• Jamie Meredith Smith
• Janet Smith, MNS, CCC-SLP
• Jaron Andrew Smith

• Chiropractor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2015; 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.