Jordan Smith, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

11470-146 Issued in WI

Practice address

645 W Ridgeview Dr
Appleton, WI 54911-1254

Phone

(920) 997-9740

NPI assigned

Mar 17, 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

State licenses

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

{
    "created_epoch": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1982230439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 W RIDGEVIEW DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111254",
            "telephone_number": "920-997-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 W RIDGEVIEW DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111254",
            "telephone_number": "920-997-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JORDAN",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-17",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WI",
            "license": "11470-146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher D Smith, OD
• Dean Smith, MD
• Heather Jean-Wittman Smith, COTA
• Jerry Smith
• Jodie Ann Smith
• Josette M Smith, LPC
• Marcia Ann Smith, ANP
• Michelle Smith
• Nikki Smith, DDS MS
• Noah Robert Smith, MD

• Massage Therapist in Appleton, WI
• Providers in Appleton, WI by specialty
• Massage Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.