Daniel Jackson Smith, PHD, AGPCNP-BC, CNE

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

311879 Issued in NY

Practice address

100 E Tupper St
Buffalo, NY 14203-1315

Phone

(716) 919-6870

NPI assigned

Mar 24, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jericho Road Ministries, Inc.Group PAC ID 5597992933, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: daniel.smith@jrchc.medentdirect.com

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.

• Jericho Road Ministries Inc.

  • Federally Qualified Health Center (FQHC)
  • Buffalo, NY
  • NPI 1972944080
  Medicare reassignment Care Compare group NPD
• Jericho Road Ministries Inc.

  • Federally Qualified Health Center (FQHC)
  • Buffalo, NY
  • NPI 1215502711
  NPD
• Prevention Point Philadelphia

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1679043152
  NPD (past)

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1902556848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E TUPPER ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E TUPPER ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031315",
            "telephone_number": "716-919-6870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303224201",
            "country_code": "US",
            "telephone_number": "404-727-7980",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301B Wende Hall",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142148013",
            "country_code": "US",
            "telephone_number": "716-829-6066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DANIEL",
        "middle_name": "JACKSON",
        "name_prefix": "Dr.",
        "credential": "PHD, AGPCNP-BC, CNE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-24",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN749716",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN280809",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN280809",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP025728",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "311879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Constance Andrea Smith, REGISTERED PHARMACIS
• Corrie E Smith, DNP
• Courtney Smith, PHARM D
• Cynthia Smith, RN
• Dana M Smith, OTR/L
• Danielle Smith
• Danielle R. Smith, O.D.
• Donald S Smith, OD
• Doris O Smith, LPN
• Elizabeth Ann Smith, PA-C

• Nurse Practitioner in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.