Jacquelyn Smith

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

106908 Issued in TX

Practice address

6640 Iola Ave
Lubbock, TX 79424-7845

Phone

(806) 786-9995

NPI assigned

Jun 14, 2016

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1730539495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 368",
            "address_2": "1809 AVE G",
            "city": "PETERSBURG",
            "state": "TX",
            "postal_code": "792500368",
            "telephone_number": "806-786-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6640 IOLA AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794247845",
            "telephone_number": "806-786-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACQUELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "106908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David G Smith, LCDC
• Derek Smith, M.D.
• Douglas Bradford Smith, PHD
• Dustin Tyler Smith, PHARMD, RPH
• Gary D Smith, MD
• Janie Laine Smith
• Jeff Smith
• Karen Smith, LPC-ASSOCIATE
• Kelli Smith, COTA
• Kelly Susanne Smith

• Occupational Therapist in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; 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.