JEFFREY A SMITH (NPI# 1104891209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104891209 |
| Entity Type | Individual |
| Full Name | JEFFREY A SMITH |
| Credential | MD |
| Practice Address |
36500 Aurora Dr Summit WI 53066-4899 |
| Practice Telephone | 2624341000 |
| Mailing Telephone | 2624341000 |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2016-02-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 43273 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1104891209 | 05 | |
| WI | WI LICENSE | 43273-20 | 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 |
36500 AURORA DR |
| City | SUMMIT |
| State | WI |
| Zip Code | 53066-4899 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346242518 | Janice Mary Beaton | Audiologist | 36500 Aurora Dr, Summit, WI 53066-4899 | 2005-06-01 |
| 1821697863 | Mackenzie L Sinnen | Audiologist | 36500 Aurora Dr, Summit, WI 53066-4899 | 2020-10-21 |
| 1811515661 | Kira Greenwood | Dietitian, Registered | 36500 Aurora Dr, Summit, WI 53066-4899 | 2020-07-08 |
| 1588281802 | Makenzie A Kirk | Physician Assistant | 36500 Aurora Dr, Summit, WI 53066-4899 | 2020-07-02 |
| 1619598786 | Olivia Joi Carlton | Physical Medicine & Rehabilitation | 36500 Aurora Dr, Summit, WI 53066-4899 | 2020-04-30 |
| 1477186633 | Aurora Advanced Healthcare Inc | Durable Medical Equipment & Medical Supplies | 36500 Aurora Dr, Summit, WI 53066-4899 | 2020-02-17 |
| 1285279844 | Elizabeth Daniels | Physician Assistant | 36500 Aurora Dr, Summit, WI 53066-4899 | 2019-11-07 |
| 1265076087 | Jessica M Zuerner | Nurse Practitioner | 36500 Aurora Dr, Summit, WI 53066-4899 | 2019-11-05 |
| 1043860570 | Megan E Shea | Physician Assistant | 36500 Aurora Dr, Summit, WI 53066-4899 | 2019-09-17 |
| 1740835073 | Kristal D Timm | Nurse Practitioner | 36500 Aurora Dr, Summit, WI 53066-4899 | 2019-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376109082 | Sharon Legwinski | Occupational Therapist | 2195 N. Summit Way, Oconomowoc, WI 53066 | 2019-05-17 |
| 1033676390 | Paladina Health, LLC | Family Medicine | Paladina Health Oconomowoc Sentry Equipment Circle, 966 Blue Ribbon Circle N, Oconomowoc, WI 53066 | 2019-02-22 |
| 1689145500 | Oconomowoc Developmental Training Center of Wisconsin LLC | Residential Treatment Facility, Emotionally Disturbed Children | 36100 Genesee Lake School, Oconomowoc, WI 53066 | 2018-12-17 |
| 1649748203 | Ginny Dacquisto | Dietitian, Registered | 1134 Lily Rd, Oconomowoc, WI 53066 | 2018-11-12 |
| 1174000764 | Aimee M Metzger | Social Worker | 405 E Forest St Ste 113, Oconomowoc, WI 53066 | 2018-07-26 |
| 1023482569 | Forefront Dermatology, S.c. | Dermatology | 1320 Pabst Farms Cir, Suite 180, Oconomowoc, WI 53066 | 2015-11-20 |
| 1962890475 | Monica Rodriguez | Counselor | 405 East Forest Street, Suite 119, Oconomowoc, WI 53066 | 2015-01-06 |
| 1518384643 | Kimberley Bevan | Pharmacist | 1284 East Summit Avenue, Suite 100, Oconomowoc, WI 53066 | 2014-03-26 |
| 1699098905 | Heidi Eckroth Nunnemacher | Counselor | 35315 Genesee Lake Road, Oconomowoc, WI 53066 | 2010-03-02 |
| 1669705240 | Oconomowoc Development Training Center Ll | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3222 N. Silver Cedar Rd., Oconomowoc, WI 53066 | 2009-09-14 |
| Find all providers in zip 53066 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770947699 | Anthony Branco | Emergency Medicine | 99 Beauvoir Ave # 3533, Summit, NJ 07901-3533 | 2016-04-06 |
| 1699204677 | Jennifer Krone | Emergency Medicine | 99 Beauvoir Ave, Summit, NJ 07901-3533 | 2017-06-05 |
| 1851823223 | Pooja Mitul Patel | Emergency Medicine | 99 Beauvoir Ave, Summit, NJ 07901-3533 | 2017-04-03 |
| 1619328739 | Alanna Ramoutar | Emergency Medicine | 99 Beauvoir Ave, Summit, NJ 07901-3533 | 2016-06-29 |
| 1831547637 | Robyn Glessner | Emergency Medicine | 99 Beauvoir Ave, Summit, NJ 07901-3533 | 2016-06-02 |
| 1982090908 | Jamie L Goehner | Emergency Medicine | 36500 Aurora Dr, Summit, WI 53066 | 2015-04-07 |
| 1245677004 | Zachary Kris Hernandez | Emergency Medicine | 99 Beauvoir Ave, Summit, NJ 07901 | 2013-06-03 |
| 1184985095 | Evan Michael Gleimer | Emergency Medicine | 99 Beauvoir Ave, Summit, NJ 07901 | 2012-06-06 |
| 1033347018 | Anita J Singh | Emergency Medicine | 99 Beauvoir Ave, Summit, NJ 07901-3533 | 2009-06-29 |
| 1093942807 | Kirsten Green | Emergency Medicine | 99 Beauvoir Ave, Summit, NJ 07901-3533 | 2009-06-18 |
| Find all providers in SUMMIT | ||||
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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.