Jamie Nicole Smith, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

001701 Issued in IA

Practice address

720 W US Highway 18
Garner, IA 50438-1022

Phone

(641) 924-0205

NPI assigned

Mar 4, 2020

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 identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Eastern Iowa Therapeutics P.C.

  • Physical Therapist
  • Garner, IA
  • NPI 1093236275
  NPD (past)

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1689209223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 W US HIGHWAY 18",
            "city": "GARNER",
            "state": "IA",
            "postal_code": "504381022",
            "telephone_number": "641-924-0205",
            "fax_number": "641-924-0207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W US HIGHWAY 18",
            "city": "GARNER",
            "state": "IA",
            "postal_code": "504381022",
            "telephone_number": "641-924-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JAMIE",
        "middle_name": "NICOLE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "001701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "001071",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Citrix",
            "affiliation": "N",
            "address_1": "720 W US Highway 18",
            "city": "Garner",
            "state": "IA",
            "country_code": "US",
            "postal_code": "504381022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tara Ann Rochleau
• Cynthia A Rurup, LISW
• Abigail Lynne Schiltz, PA-C
• Breanna Jo Scott Marker, OD
• Leslie Susan Sloan, MSN, ARNP, PMHNP-BC
• John Lee Steenblock
• Roy A Tesene, DDS
• Kendra S Ulicki, ANRP
• Alexander P Vangerpen, DDS
• Vidal Family Dentistry

• All providers in Garner, IA
• Athletic Trainer in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.