Jennifer Smallwood

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

10821 West Hickory Avenue
Peggs School
Peggs, OK 74452

Phone

(918) 260-0199

NPI assigned

Mar 3, 2016

Last updated

Mar 3, 2016By the provider in NPPES

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

Other identifiers 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peggs Public School

  • Local Education Agency (LEA)
  • Peggs, OK
  • NPI 1093881419
  NPD (past)
• Peggs Public School

  • Local Education Agency (LEA)
  • Peggs, OK
  • NPI 1205900727
  NPD (past)

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1952761926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 119",
            "city": "PEGGS",
            "state": "OK",
            "postal_code": "744520119",
            "telephone_number": "918-598-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10821 WEST HICKORY AVENUE",
            "address_2": "PEGGS SCHOOL",
            "city": "PEGGS",
            "state": "OK",
            "postal_code": "74452",
            "telephone_number": "918-260-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLWOOD",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047434244",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• June Roseann Ballard, LPC
• Brianna Louise Begley
• Peggs Public School
• Peggs Public School

• Community Health Worker in Peggs, OK
• Providers in Peggs, OK by specialty
• Community Health Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.