Jess Smith, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

51720 Issued in CA

Practice address

500 Ala Moana Blvd Ste 7-230
Honolulu, HI 96813-4987

Phone

(808) 582-0459

NPI assigned

Nov 1, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1891071080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1247 KAMEHAME DR",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968253506",
            "telephone_number": "229-326-2581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ALA MOANA BLVD STE 7-230",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968134987",
            "telephone_number": "808-582-0459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5395 Ruffin Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921231338",
            "country_code": "US",
            "telephone_number": "229-326-2581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-01",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0007584",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110007462",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "1098380",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah L. Smith
• Denali Smith
• Douglas L Smith, M.D.
• Holly Smith
• James Edwin Smith III, M.D.
• Jolene Lona Smith, PT , COMT
• Kendra Renee Smith
• Logan Laura Smith, RBT
• Lyndsey Smith, NP
• Makila Rae Smith

• Physician Assistant in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Physician Assistant in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.