Individual provider Active NPI

James Dickey Smith, DC

  • Chiropractor
  • St Joseph, MO
National Provider Identifier
1912939059
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
006432 Issued in MO
Practice address
1802 N Woodbine Rd
St Joseph, MO 64506
Phone
(816) 232-5113
Fax
(816) 232-0453
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 006432 MO Primary

Addresses

Primary practice location

1802 N Woodbine Rd
St Joseph, MO 64506

Mailing address

1802 N Woodbine Rd
PO Box 6423
St Joseph, MO 64506
Phone (816) 232-5113

Other identifiers 3

IdentifierTypeStateIssuer
P00120973OtherMORR MEDICARE
75385310MedicaidMO
10001164203OtherMOCOMMUNITY HEALTH PLAN

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912939059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 N WOODBINE RD",
            "address_2": "PO BOX 6423",
            "city": "ST JOSEPH",
            "state": "MO",
            "postal_code": "64506",
            "telephone_number": "816-232-5113",
            "fax_number": "816-232-0453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 N WOODBINE RD",
            "city": "ST JOSEPH",
            "state": "MO",
            "postal_code": "64506",
            "telephone_number": "816-232-5113",
            "fax_number": "816-232-0453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JAMES",
        "middle_name": "DICKEY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "006432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00120973",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75385310",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH PLAN",
            "identifier": "10001164203",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.