Jaqualyn A Smith

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

308 N Aspen Ave
Broken Arrow, OK 74012-2205

Phone

(539) 777-0940

NPI assigned

Nov 16, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Teach Me LLC

  • Behavior Analyst
  • Carrollton, TX
  • NPI 1124332911
  NPD (past)
• Therapy & Beyond Medical Management, LLC

  • Developmental Disabilities Clinic/Center
  • Carrollton, TX
  • NPI 1669146171
  NPD (past)

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

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1902408727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7343 S UTICA AVE APT 1214",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 N ASPEN AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122205",
            "telephone_number": "539-777-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JAQUALYN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cayleigh Smith
• Chelsea Smith
• Cheryl L Smith, RD
• Crystal Lea Smith, APRN
• Dru Cody Smith, D.P.T.
• Jason Michael Smith
• Jordon Caine Smith, D.D.S
• Kristen Smith, D.C.
• Lisa Janell Smith, COTA
• Madison Hannah Smith, RD, LD

• Behavior Technician in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Behavior Technician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.