DR. JEFFREY P. SMITH (NPI# 1760578835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760578835 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY P. SMITH |
| Credential | M.D. |
| Practice Address |
4801 Troup Hwy S Suite 301 Tyler TX 75703 |
| Mailing Address |
4801 Troup Hwy South Suite 301 Tyler TX 75703 |
| Practice Telephone | 9035953220 |
| Practice Fax Number | 9035953887 |
| Mailing Telephone | 9035953220 |
| Mailing Fax Number | 9035953887 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2011-10-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | J4527 | TX | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | GROUP MEDICARE | 00850X | 01 |
| TX | BLUE CROSS BLUE SHIELD | 8R1210 | 01 |
| TX | MEDICAL LICENSE | J4527 | 01 |
| TX | GROUP BC/BS | 0026MA | 01 |
| TX | 118586004 | 05 | |
| TX | GROUP MEDICAID | 169940701 | 01 |
| TX | CLIA | 45D1034142 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437768207 | Jeffrey Michael Smith | Nurse Practitioner | 96 Sutton St, Northbridge, MA 01534-1003 | 2020-07-28 |
| 1558989582 | Jeffrey Smith | Registered Nurse | 9200 Basil Ct Ste 100, Upper Marlboro, MD 20774-5309 | 2020-07-07 |
| 1447723101 | Jeffrey Clinton Smith | Massage Therapist | 254 W Palmer Lake Dr, Pueblo West, CO 81007-2877 | 2019-01-05 |
| 1518457738 | Jeffrey David Smith | Student in an Organized Health Care Education/Training Program | 1400 Locust Street Ermire, Suite 11516, Pittsburgh, PA 15219-5114 | 2018-05-14 |
| 1992252100 | Jeffrey Smith | Community/Behavioral Health | 99 Royal Vista Dr Unit 408, Branson, MO 65616-6237 | 2016-09-06 |
| 1790132900 | Jeffrey Smith | Registered Nurse | 209 Cedar Grove Dr, Youngsville, LA 70592-5853 | 2016-05-17 |
| 1538586680 | Jeffrey Smith II | Counselor | 3300 N Tenaya Way Apt 2087, Las Vegas, NV 89129-7416 | 2014-03-26 |
| 1710316773 | Jeffrey Smith | Registered Nurse | 273 Hundred Oaks Pkwy, Summerville, SC 29483-8193 | 2013-11-10 |
| 1487901583 | Jeffrey Dean Smith Jr. | Licensed Vocational Nurse | 1782 W Columbia Way, Hanford, CA 93230-1104 | 2012-08-07 |
| 1326315870 | Jeffrey Paul Smith | Physical Therapy Assistant | 1625 Ocala Ave, Johnstown, PA 15902-3526 | 2011-11-29 |
| Street Address |
4801 TROUP HWY S SUITE 301 |
| City | TYLER |
| State | TX |
| Zip Code | 75703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
| 1770052532 | Refinery Chiropractic LLC | Chiropractor | 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 | 2018-11-21 |
| 1215419353 | Deidre Lynn Fergason | Occupational Therapy Assistant | 3505 Old Jacksonville Hwy, Tyler, TX 75703 | 2018-09-05 |
| 1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
| 1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
| 1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
| 1427572544 | Cody Wayne Graham | Pharmacist | 5415 S. Broadway Ave., Tyler, TX 75703 | 2017-07-31 |
| 1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
| 1427570084 | Darah Lynne Dahlem | Speech-Language Pathologist | 401 E. Front Street Ste 123, Tyler, TX 75703 | 2017-07-14 |
| 1194267468 | Herman Lester Hampton Jr. | Surgery | 5803 Regents Row, Tyler, TX 75703 | 2016-11-17 |
| Find all providers in zip 75703 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144572512 | Parent Services Center, Inc. | Specialist | 4411 Old Bullard Rd Ste 602, Tyler, TX 75703-1215 | 2012-10-10 |
| 1093032880 | Misty M Bridges | Specialist | 106 E Heritage Dr Ste 5e, Tyler, TX 75703-5112 | 2010-05-03 |
| 1972820611 | Leah F Woodruff | Specialist | 201 Winchester Dr, Tyler, TX 75701-8847 | 2010-04-20 |
| 1457587248 | Marissa Borromeo | Specialist | 4914 Inverness Dr, Tyler, TX 75703-2604 | 2009-06-07 |
| 1265613889 | Appletree Pediatrics, P.a. | Specialist | 1306 Doctors Dr, Tyler, TX 75701-2262 | 2007-11-26 |
| 1093803116 | Robert L. Boyne, M.d., P.a. | Specialist | 700 Olympic Plaza Cir Ste 912, Tyler, TX 75701-1955 | 2006-10-11 |
| 1952409377 | Rosenfield, Md. Pa | Specialist | 1305 Dr Drive, Tyler, TX 75701-3343 | 2006-09-20 |
| 1275571861 | Joseph Lynn Prud'homme Sr. | Specialist | 1015 E Idel St, Tyler, TX 75701-2025 | 2006-06-03 |
| 1225023070 | Adagio Dermatology and Aesthetics, P.a. | Specialist | 455 Rice Road, Ste. 104, Tyler, TX 75703-3604 | 2005-09-19 |
| 1205837424 | Dannise Beckley | Specialist | 5791 Copeland Rd, Tyler, TX 75703-3905 | 2005-08-10 |
| Find all providers in TYLER | ||||
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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.