Jerrica Smith
Behavior Technician in Fort Wayne, IN. Individual provider (NPI-1).
NPI number1497417166
StatusActive
Last updated in NPPESOct 11, 2021
Details
- NPI
- 1497417166
- Entity type
- Individual (NPI-1)
- Name
- Jerrica Smith
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 11, 2021
- Certification date
- Oct 11, 2021
- Last updated
- Oct 11, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
2825 Hillegas RdFort Wayne, IN 46808-3859
Phone 260-585-7655
Mailing address
4935 Hillegas RdFort Wayne, IN 46818-1906
Phone 260-338-1241
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 1,240 Behavior Technician providers in Fort Wayne · All 11,302 providers in Fort Wayne
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