Jacob Dennis Smith, CPRS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

9945 Issued in MN

Practice address

1826 Commerce Dr
North Mankato, MN 56003-1800

Phone

(507) 229-0350

Fax

(507) 216-0371

NPI assigned

Dec 23, 2024

Last updated

Dec 23, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Mankato Chemical Health, LLC

  • Addiction (Substance Use Disorder) Counselor
  • North Mankato, MN
  • NPI 1124684907
  NPD

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

{
    "created_epoch": "1734912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1679381693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1826 COMMERCE DR",
            "city": "NORTH MANKATO",
            "state": "MN",
            "postal_code": "560031800",
            "telephone_number": "507-229-0350",
            "fax_number": "507-216-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 COMMERCE DR",
            "city": "NORTH MANKATO",
            "state": "MN",
            "postal_code": "560031800",
            "telephone_number": "507-229-0350",
            "fax_number": "507-216-0371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACOB",
        "middle_name": "DENNIS",
        "credential": "CPRS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-23",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "MN",
            "license": "9945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikaela Jean Sellner
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• Parrish Troy Skrien, D.C.
• Emma Smith, MS, RD, LD
• Solhaven Birth Center, LLC
• Solhaven Birth Center, LLC
• Maryn Elizabeth Somerville
• Amy Jo Sorensen, DO
• South Central Service Cooperative

• Peer Specialist in North Mankato, MN
• Providers in North Mankato, MN by specialty
• Peer Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.