NPIMap

Individual provider Active NPI

Jennifer E Smith, PA

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1811260821
Registry record updated Oct 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
APA2119 Issued in OK
Practice address
820 NE 15TH St
Oklahoma City, OK 73104-4602
Phone
(405) 271-6242
Fax
(405) 271-2887
NPI assigned
Feb 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X APA2119 OK Primary

Addresses

Primary practice location

820 NE 15TH St
Oklahoma City, OK 73104-4602

Mailing address

820 NE 15TH St
Oklahoma City, OK 73104-4602
Phone (405) 271-6242

Other names 1

  • Jennifer E Wellman Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jsmith81571@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120607000092 OK Practitioner - Physician Assistant 3375707185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

825 NE 13TH St
Oklahoma City, OK 73104-5005
Phone (405) 271-7410

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.73 of 100Reported as group
Quality
71.5
Promoting interoperability
100
Improvement activities
40
Cost
56.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2119OKMDRegistered Dietitian
APA2119OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Medical Research Foundation CurrentSince Apr 1, 2013 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients

Locations

825 NE 13th St
Oklahoma City, OK 73104
Phone (405) 271-1500

Interoperability endpoints

  • Direct secure messaging: jsmith81571@direct-ehr-ssmhc.com

Organizations & group practices 4

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 8

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": "1329868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602979200000",
    "number": "1811260821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 NE 15TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044602",
            "telephone_number": "405-271-6242",
            "fax_number": "405-271-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 NE 15TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044602",
            "telephone_number": "405-271-6242",
            "fax_number": "405-271-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-22",
        "last_updated": "2020-10-18",
        "certification_date": "2020-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "APA2119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsmith81571@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jsmith81571@direct-ehr-ssmhc.com",
            "address_1": "820 NE 15th St",
            "city": "Oklahoma City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731044602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "820 NE 15th St",
            "city": "Oklahoma City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731044602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WELLMAN",
            "middle_name": "E",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.