Individual provider Active NPI

Jeremy Smith, M.D.

  • Emergency Medicine Physician
  • Wenatchee, WA
National Provider Identifier
1699988832
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD60259685 Issued in WA
Practice address
1201 S Miller St
Wenatchee, WA 98801-3201
Phone
(509) 662-1511
NPI assigned
May 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD60259685 WA Primary

Addresses

Primary practice location

1201 S Miller St
Wenatchee, WA 98801-3201

Mailing address

1201 S Miller St
Wenatchee, WA 98801-3201
Phone (509) 662-1511

Other identifiers 3

IdentifierTypeStateIssuer
P01775112OtherWARR MEDICARE PTAN WVH
289526OtherWALNI
1699988832MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120307000827 WA Practitioner - Emergency Medicine 7618028507 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Albany Medical College of Union University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 S Miller St
Wenatchee, WA 98801-3201
Phone (509) 662-2208

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Central Washington Health Services Association CurrentSince Feb 1, 2012 Accepting new patients
Central Washington Health Services Association CurrentSince Feb 1, 2012 Accepting new patients
Wenatchee Valley Hospital CurrentSince Jul 21, 2013 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas PastSince Jul 1, 2010 Accepting new patients
University of Texas Southwestern Medical Center at Dallas PastSince Jul 1, 2010 Accepting new patients

Locations

303 Cottage Ave
Cashmere, WA 98815
Phone (509) 782-1541

801 E Wheeler Rd
Moses Lake, WA 98837
Phone (509) 765-5606

840 E Hill Ave
Moses Lake, WA 98837
Phone (509) 764-6400

916 Koala Dr
Omak, WA 98841
Phone (509) 826-1800

17 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2174

203 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2151

100 Highline Dr
Wenatchee, WA 98802
Phone (509) 884-0614

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

1201 S Miller St
Wenatchee, WA 98801
Phone (509) 662-2208

707 N Emerson Ave
Wenatchee, WA 98801
Phone (509) 662-6109

Interoperability endpoints

  • Direct secure messaging: jsmith17211@edirect.chehr.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1699988832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S MILLER ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013201",
            "telephone_number": "509-662-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S MILLER ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013201",
            "telephone_number": "509-662-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEREMY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD60259685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN WVH",
            "identifier": "P01775112",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI",
            "identifier": "289526",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699988832",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

Verify at the official NPI Registry.