Individual provider Active NPI

Jonathan Smith, ARNP

  • Nurse Practitioner
  • Des Moines, IA
National Provider Identifier
1932522547
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A115359 Issued in IA
Practice address
411 Laurel St Ste A120
Des Moines, IA 50314-3027
Phone
(515) 643-7900
Fax
(515) 643-7901
NPI assigned
Feb 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11539 IA
Nurse Practitioner 363L00000X A115359 IA Primary

Addresses

Primary practice location

411 Laurel St Ste A120
Des Moines, IA 50314-3027

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20140403002223 IA Practitioner - Nurse Practitioner 7911139050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

330 Laurel St
Suite 1200
Des Moines, IA 50314-3044
Phone (515) 643-6290

411 Laurel St
Des Moines, IA 50314-3027

800 E 1St St
Ankeny, IA 50021-2077

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11539IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics Inc CurrentSince Dec 31, 2017 Accepting new patients
Mercy Clinics, Inc. Current Accepting new patients
Boone County Hospital Past Accepting new patients

Locations

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

1601 NW 114th St
Ste 347
Des Moines, IA 50325
Phone (515) 222-7350

Interoperability endpoints

  • Direct secure messaging: jsmith3958092@direct.trinity-health.org

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1391385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1932522547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-643-7900",
            "fax_number": "515-643-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 LAUREL ST STE A120",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143027",
            "telephone_number": "515-643-7900",
            "fax_number": "515-643-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JONATHAN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-03",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "11539",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A115359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.