Jerry Smith, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

C51861 Issued in CA

Practice address

1630 E Herndon Ave
Fresno, CA 93720-3305

Phone

(559) 256-5200

Fax

(559) 256-5376

NPI assigned

Nov 23, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jerry.smith.p1@direct.spocortho.nextgenshare.com
• Direct secure messaging: jerry.smith.p1@direct.lcthc.nextgenshare.com

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.

• Genesis Specialty Hospitals II, LLC

  • General Acute Care Hospital
  • New Orleans, LA
  • NPI 1831198175
  NPD (past)

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780667667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203305",
            "telephone_number": "559-256-5200",
            "fax_number": "559-256-5376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203305",
            "telephone_number": "559-256-5200",
            "fax_number": "559-256-5376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JERRY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "C51861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WASHINGTON",
            "identifier": "0195819",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00220553",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie Smith
• Jared Smith, LCSW
• Jeanette Smith
• Jeffery Smith
• Jennifer Toler Smith, PSY.D.
• Jervy William Smith, OD
• Juanita Rachel Smith, RN
• Julian Shane Smith, M.D.
• Juliana Janae Smith
• Justin Smith, OD

• Physical Medicine & Rehabilitation Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.