Individual provider Active NPI

Jordin Brielle Smiley, ATC

  • Athletic Trainer
  • Richmond, KY
National Provider Identifier
1902301989
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
5552 Issued in OH
Practice address
521 Lancaster Ave
Richmond, KY 40475-3102
Phone
(859) 622-1742
NPI assigned
Mar 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 5552 OH Primary

Addresses

Primary practice location

521 Lancaster Ave
Richmond, KY 40475-3102

Mailing address

410 Jason Dr Apt B15
Richmond, KY 40475-2282
Phone (513) 601-4112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5552OHMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1902301989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 JASON DR APT B15",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404752282",
            "telephone_number": "513-601-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 LANCASTER AVE",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404753102",
            "telephone_number": "859-622-1742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMILEY",
        "first_name": "JORDIN",
        "middle_name": "BRIELLE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "5552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.