Individual provider Active NPI

Jennifer Ruth Smothermon, LPC LMFT

  • Marriage & Family Therapist
  • Abilene, TX
National Provider Identifier
1669494472
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT501543533
Practice address
1502 N 1St St
Abilene, TX 79601-5602
Phone
(325) 672-9999
Fax
(325) 672-5237
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 17580200765 TX
Marriage & Family Therapist 106H00000X LMFT501543533 Primary

Addresses

Primary practice location

1502 N 1St St
Abilene, TX 79601-5602

Mailing address

1502 N 1St St
Abilene, TX 79601-5602
Phone (325) 672-9999

Other identifiers 1

IdentifierTypeStateIssuer
149272001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240621003828 TX Practitioner - Mental Health Counselor 5890238562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Baptist Mission Action IncGroup PAC ID 7214959121, 7 clinicians

Practice addresses (Care Compare)

1502 N 1St St
Abilene, TX 79601-5602
Phone (325) 672-9999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17580200765TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
First Baptist Mission Action Inc CurrentSince Apr 14, 2024 Accepting new patients

Locations

1502 N 1st St
Abilene, TX 79601
Phone (325) 672-9999

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1669494472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 N 1ST ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796015602",
            "telephone_number": "325-672-9999",
            "fax_number": "325-672-5237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 N 1ST ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796015602",
            "telephone_number": "325-672-9999",
            "fax_number": "325-672-5237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOTHERMON",
        "first_name": "JENNIFER",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "LPC LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "17580200765",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": "LMFT501543533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149272001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.