JEFFERY DEWARD SMITH (NPI# 1083691109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083691109 |
| Entity Type | Individual |
| Full Name | JEFFERY DEWARD SMITH |
| Credential | PA |
| Practice Address |
4540 E Baseline Rd Suite#114 Mesa AZ 85206-4613 |
| Mailing Address |
Po Box 682 Gilbert AZ 85299-0682 |
| Practice Telephone | 4806330294 |
| Practice Fax Number | 4806330604 |
| Mailing Telephone | 4806330294 |
| Mailing Fax Number | 4806330604 |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
2409 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | MS1236935 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386167401 | Jeffery Dan Smith | Pharmacist | 146 West 200 South, Kamas, UT 84036 | 2017-07-20 |
| 1497197669 | Jeffery Smith | Counselor | 4991 E Mckinley Ave Ste 112, Fresno, CA 93727-1966 | 2013-07-29 |
| 1851659908 | Jeffery Kenneth Smith | Physical Therapist | 8002 Waldorf Ct, Orlando, FL 32817-1586 | 2012-04-26 |
| 1982806923 | Jeffery Smith | Family Medicine | 2307 La Porte Ave, Suite 4, Valparaiso, IN 46383-7028 | 2007-06-01 |
| 1982730339 | Jeffery Owen Smith | Pharmacist | 3020 E Main St, Lot V-120, Mesa, AZ 85213-9488 | 2007-02-27 |
| 1215957105 | Jeffery William Smith | Dentist | 630 Woods Creek Dr, Sonora, CA 95370-4817 | 2006-07-20 |
| 1861961153 | Jeffery Michael Smith | Physician Assistant | 441 S Redwood Rd, Slc, UT 84104-3539 | 2018-11-16 |
| 1063913648 | Jeffery David Smith | Occupational Therapist | 1255 W Silverbell Rd, Lake Orion, MI 48359-1345 | 2018-02-28 |
| 1356734966 | Jeffery Smith | Physician Assistant | 400 Ne Mother Joseph Pl, Vancouver, WA 98664-3200 | 2015-03-07 |
| 1902101207 | Jeffery Dee Smith | Pharmacist | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2011-01-18 |
| Street Address |
4540 E BASELINE RD SUITE#114 |
| City | MESA |
| State | AZ |
| Zip Code | 85206-4613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225031503 | Jo Merriwether Knatz | Obstetrics & Gynecology | 4540 E Baseline Rd, Ste 115, Mesa, AZ 85206-4617 | 2005-05-31 |
| 1770034787 | Amanda Hines Kwilosz | Physician Assistant | 4540 E Baseline Rd, #113, Mesa, AZ 85206-4613 | 2016-10-14 |
| 1225489511 | Wize Healthcare LLC | Pain Medicine | 4540 E Baseline Rd, 105, Mesa, AZ 85206-4613 | 2016-06-28 |
| 1366854721 | Cbd Healthcare LLC | Chiropractor | 4540 E Baseline Rd, #105, Mesa, AZ 85206-4613 | 2014-05-20 |
| 1619399714 | Cd Healthcare,llc | Physical Medicine & Rehabilitation | 4540 E Baseline Rd, Suite 105, Mesa, AZ 85206-4613 | 2014-01-09 |
| 1740601962 | Calgary Medical LLC | Physical Medicine & Rehabilitation | 4540 E Baseline Rd, Suite 105, Mesa, AZ 85206-4613 | 2013-12-16 |
| 1316388648 | Annette Villalobos Lopez | Nurse Practitioner | 4540 E Baseline Rd, Mesa, AZ 85206-4613 | 2013-07-15 |
| 1912202904 | Craig Brian Defries | Chiropractor | 4540 E Baseline Rd, Suite 105, Mesa, AZ 85206-4613 | 2011-01-21 |
| 1063655223 | The Wellness Way, Inc. | Chiropractor | 4540 E Baseline Rd, Suite 112, Mesa, AZ 85206-4613 | 2009-04-16 |
| 1467692897 | Brian Wortzel | Physician Assistant | 4540 E Baseline Rd, 115, Mesa, AZ 85206-4613 | 2009-02-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693062 | Inner Balance Counseling LLC | Counselor | 4111 E Auto Valley Drive, Suite 101, Mesa, AZ 85206 | 2020-09-14 |
| 1356978969 | Choices 4 Change Counseling and Coaching LLC | Social Worker | 3707 E Southern Ave., Suite 2027, Mesa, AZ 85206 | 2020-03-24 |
| 1023651288 | Jason Mcclure | Hearing Instrument Specialist | 5540 E Broadway Rd., Mesa, AZ 85206 | 2019-10-21 |
| 1255995361 | Vhs of Phoenix Inc | General Acute Care Hospital | 5750 E. Baseline Rd., Mesa, AZ 85206 | 2019-04-24 |
| 1932682184 | Adam Fishel Frose | Psychologist | 4555 E Inverness Ave Ste 112, Mesa, AZ 85206 | 2018-09-13 |
| 1376024737 | Robyn Kathleen Hall | Psychologist | 4115 East Valley Auto Drive, Suite 208, Mesa, AZ 85206 | 2018-08-23 |
| 1790264984 | Perspective Health, LLC | Clinic/Center | 1959 S. Power Rd, Suite 103, #206, Mesa, AZ 85206 | 2018-08-09 |
| 1033605159 | Rebecca Ann Maro | Nurse Practitioner | 6750 E Baywood Ave Ste 502, Mesa, AZ 85206 | 2018-07-02 |
| 1982195624 | Spark Performance and Physiotherapy | Clinic/Center | 6056 East Basline Road, Suite 147, Mesa, AZ 85206 | 2018-05-29 |
| 1336645993 | Ashley Wright | Audiologist-Hearing Aid Fitter | 1423 S Higley Rd Ste 119, Mesa, AZ 85206 | 2018-04-03 |
| Find all providers in zip 85206 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962986349 | Amber Lynn Maison | Physician Assistant | 4540 E Baseline Rd Ste 113, Mesa, AZ 85206-4617 | 2018-09-20 |
| 1821549619 | Briana Dawn Johnson | Physician Assistant | 455 N Mesa Dr Ste 16e, Mesa, AZ 85201-5995 | 2016-10-17 |
| 1659741031 | Jared Bevell | Physician Assistant | 844 E 7th Pl, Mesa, AZ 85203-6404 | 2015-09-29 |
| 1649507088 | Klint Layton Webb | Physician Assistant | 3130 E Baseline Rd Ste 103-104, Mesa, AZ 85204-7290 | 2009-11-05 |
| 1194961540 | Jeffrey R Smolin | Physician Assistant | 2034 S Alma School Rd Ste 2, Mesa, AZ 85210-4004 | 2009-01-06 |
| 1235389156 | Tessa M Tibben | Physician Assistant | 4855 E Brown Rd Ste 100, Mesa, AZ 85205-8007 | 2008-09-27 |
| 1639353808 | Brittany S Wheeler | Physician Assistant | 2310 E. Brown Rd, Mesa, AZ 85213 | 2007-12-24 |
| 1891995296 | Kellie M Earle P.a. | Physician Assistant | 4135 So. Power Rd, Suite 129, Mesa, AZ 85212 | 2007-07-23 |
| 1881778348 | Robert James Kalmbach | Physician Assistant | 4850 E Baseline #118, Mesa, AZ 85206 | 2006-10-24 |
| 1336255264 | Greenfield Family Medicine LLC | Physician Assistant | 1244 N. Greenfield Rd., Suite 104, Mesa, AZ 85205 | 2006-08-22 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.