DR. JACK MICHAEL SMITH (NPI# 1346687720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346687720 |
| Entity Type | Individual |
| Full Name | DR. JACK MICHAEL SMITH |
| Credential | MD |
| Practice Address |
1100 Grampian Blvd Williamsport PA 17701 |
| Mailing Address |
1201 Grampian Blvd Williamsport PA 17701-1900 |
| Practice Telephone | 5703268457 |
| Practice Fax Number | 5703207989 |
| Enumeration Date | 2013-05-26 |
| Last Update Date | 2018-07-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
MD463374 | PA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669885687 | Jack Smith | Social Worker | 933 Sw 3rd St, Moore, OK 73160-2261 | 2014-06-06 |
| 1659450773 | Jack Steven Smith | Chiropractor | 1815 W Missouri Ave Ste 102, Phoenix, AZ 85015-3047 | 2006-11-02 |
| 1043248818 | Jack Dale Smith | Urology | 1321 Cottonwood St, Suite 302, Woodland, CA 95695-5131 | 2006-06-29 |
| 1528036704 | Jack Bradley Smith | Physician Assistant | 4401 W Memorial Rd, Oklahoma City, OK 73134-1785 | 2006-03-14 |
| 1538133426 | Jack Dempsey Smith | Dentist | 2919 Colony Rd, Durham, NC 27705-5595 | 2006-02-15 |
| 1891780581 | Jack D Smith | Specialist | 133 Donohoe Rd, Greensburg, PA 15601-6986 | 2005-09-19 |
| 1952593691 | Jack W. Smith | Family Medicine | 5111 Leesburg Pike, Skyline 5, Suite 601, Falls Church, VA 22041-3251 | 2007-08-16 |
| 1710191564 | Jack Smith | Counselor | 15040 S Ravinia Ave Ste 44, Orland Park, IL 60462-3173 | 2007-05-10 |
| 1356489462 | Jack Brian Smith | Dentist | 160 Three Rivers Dr Ne, Ste. 1600, Rome, GA 30161-2303 | 2007-02-01 |
| 1871538041 | Jack Coldwell Smith IIi | Internal Medicine | 409 Cottage Rd, Carthage, TX 75633-1466 | 2006-06-19 |
| Street Address |
1100 GRAMPIAN BLVD |
| City | WILLIAMSPORT |
| State | PA |
| Zip Code | 17701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902804339 | Jennifer Ellyn Bayer | Nurse Practitioner | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2005-07-11 |
| 1225647548 | Justin Silverstrim | Physician Assistant | 1100 Grampian Blvd, Williamsport, PA 17701-1907 | 2020-07-23 |
| 1346862745 | Kyle Creighton Thiel | Nurse Practitioner | 1100 Grampian Blvd, Williamsport, PA 17701-1907 | 2020-05-08 |
| 1598399610 | Jacquelyn Elaine Baker | Social Worker | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2020-02-27 |
| 1811531304 | Elizabeth Belz | Physician Assistant | 1100 Grampian Blvd, Williamsport, PA 17701-1907 | 2019-10-29 |
| 1881157618 | Stephanie Herman | Nurse Practitioner | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2019-04-09 |
| 1376017947 | Amanda Marie Swanson | Nurse Practitioner | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2019-01-17 |
| 1225500770 | Upmc Williamsport | Clinic/Center | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2018-12-21 |
| 1649746488 | Upmc Williamsport | Psychiatric Unit | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2018-10-19 |
| 1164907226 | Robin Elaine Sammons | Nurse Practitioner | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2018-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184267809 | Charlene Angella Pitter | Nurse Practitioner | 170 Warren Ave, Williamsport, PA 17701 | 2019-10-25 |
| 1396395299 | Susan E Fetzer | Occupational Therapy Assistant | Upmc Susquehanna,625 West Edwin Street, Williamsport, PA 17701 | 2019-09-13 |
| 1184280984 | Craig Andrew Tuller | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency, 740 High Street, Suite 4001, Williamsport, PA 17701 | 2019-05-16 |
| 1760048045 | Michael Harvey | Student in an Organized Health Care Education/Training Program | 740 High St. Suite 4001, Williamsport, PA 17701 | 2019-05-13 |
| 1275196008 | Olivia Fladmark | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency 740 High St, Suite 4001, Williamsport, PA 17701 | 2019-04-17 |
| 1528551231 | Mark Hampton Chiropractic Inc. | Durable Medical Equipment & Medical Supplies | 1111 East 3rd Street, Williamsport, PA 17701 | 2018-06-08 |
| 1548710882 | Central Pennsylvania Rehabilitation Medicine, Inc | Physical Medicine & Rehabilitation | 460 River Ave Ste 1, Williamsport, PA 17701 | 2016-10-11 |
| 1376096784 | Christine Kessler | Physician Assistant | One College Ave, Penna. College of Tech, Pa Program Dif 123, Williamsport, PA 17701 | 2016-08-02 |
| 1629440276 | Matthew Ray Rebuck | Specialist/Technologist | 220 N Reach Rd, Williamsport, PA 17701 | 2015-10-22 |
| 1508237223 | Neihl Williamson | Physician Assistant | 1205 Grampian Blvd Ste 3c, Williamsport, PA 17701 | 2015-10-08 |
| Find all providers in zip 17701 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902219702 | Kyle Matthew Weiss | Physical Medicine & Rehabilitation | 501 Cetronia Rd Ste 125, Allentown, PA 18104-9569 | 2014-06-09 |
| 1558771089 | Christian Boris Acharte | Physical Medicine & Rehabilitation | 700 Horizon Circle Ste 206, Chalfont, PA 18914-3967 | 2014-05-06 |
| 1649618349 | David Stephen Mills | Physical Medicine & Rehabilitation | 8775 Norwin Ave Ste 108, North Huntingdon, PA 15642 | 2013-06-05 |
| 1306184858 | Lighthouse Medical, LLC | Physical Medicine & Rehabilitation | 301 E. Pleasant Valley Blvd, Altoona, PA 16602 | 2013-01-17 |
| 1710243787 | Alcinto Steven Guirand | Physical Medicine & Rehabilitation | 1450 Scalp Ave Ste 2100, Johnstown, PA 15904-3374 | 2012-04-04 |
| 1578848651 | Performance Spine and Sports Medicine of Newtown, LLC | Physical Medicine & Rehabilitation | 828 Newtown Yardley Road, A, Newtown, PA 18940 | 2011-10-20 |
| 1588974588 | Greater Philadelphia Pain Management Center PC | Physical Medicine & Rehabilitation | 104 Bailey Dr, North Wales, PA 19454-4526 | 2010-10-12 |
| 1245545813 | Maureen Murphy Ginsburg | Physical Medicine & Rehabilitation | 551 W Mahoning St, Punxsutawney, PA 15767 | 2010-08-08 |
| 1205071297 | Bethia A. Cawley | Physical Medicine & Rehabilitation | 2804 Southampton Rd, Philadelphia, PA 19154-1207 | 2008-12-05 |
| 1891953188 | Paris Hughes | Physical Medicine & Rehabilitation | 2447 N 54th St, Philadelphia, PA 19131-2423 | 2008-05-23 |
| Find all providers with the same taxonomy | ||||
| City | WILLIAMSPORT |
| Zip Code | 17701 |
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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.