MR. JERRY SOLON SMITH PA-C NPI 1578858742

NPI Information

  • NPI: 1578858742
  • Provider Name: MR. JERRY SOLON SMITH, PA-C
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4787 ALBEN BARKLEY DRIVE
    PADUCAH, KY
    ZIP 42002
  • Phone: (270) 442-9461

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NPI Details

MR. Jerry Solon Smith, PA-C is a medical physician assistant in Paducah, KY. MR. Jerry Solon Smith, PA-C NPI is 1578858742. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4787 ALBEN BARKLEY DRIVE
PADUCAH, KY
ZIP 42002
Phone: (270) 442-9461
Fax: (270) 441-0079

The NPI 1578858742 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 6/15/2011 and was last updated on 6/8/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedicalPA1645KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1K003351MEDICARE PINKENTUCKY
2K003352MEDICARE PINKENTUCKY
37100226410MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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