Individual provider Active NPI

Jeffery O Smith, FNP

  • Nurse Practitioner
  • Medford, OR
National Provider Identifier
1871532689
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
13401 Issued in CO
Practice address
19 Myrtle St
Medford, OR 97504-7337
Phone
(541) 773-3863
Fax
(541) 776-2892
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 13401 CO Primary

Addresses

Primary practice location

19 Myrtle St
Medford, OR 97504-7337

Mailing address

19 Myrtle St
Medford, OR 97504-7337
Phone (541) 773-3863

Other identifiers 1

IdentifierTypeStateIssuer
07920077MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090805000168 TX Practitioner - Nurse Practitioner 7517010747 Reassigns benefits to 1 organization
I20150223001343 NM Practitioner - Nurse Practitioner 7517010747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.65 of 100Reported as group
Quality
68.3
Improvement activities
40
Cost
86.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13401COMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Jan 1, 2015 Accepting new patients
Presbyterian Healthcare Services Current Accepting new patients
Presbyterian Healthcare Services CurrentSince Jan 1, 2015 Accepting new patients
Thoreau Clinic CurrentSince Apr 26, 2019 Accepting new patients
DHHS PHS Naihs Crownpoint Hospital Current Accepting new patients
Pueblo Pintado Clinic Current Accepting new patients

Locations

5901 Harper Dr NE
Albuquerque, NM 87109
Phone (505) 823-8233

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

609 Christopher Dr
Belen, NM 87002
Phone (505) 861-1771

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

4801 Beckner Rd
Santa Fe, NM 87507
Phone (505) 772-1234

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1871532689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 MYRTLE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047337",
            "telephone_number": "541-773-3863",
            "fax_number": "541-776-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 MYRTLE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047337",
            "telephone_number": "541-773-3863",
            "fax_number": "541-776-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEFFERY",
        "middle_name": "O",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "13401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07920077",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.