DR. JACOB GORDON SMITH DO
NPI 1366337511
Student in an Organized Health Care Education/Training Program in Detroit, MI
About Dr. Jacob Gordon Smith Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JACOB GORDON SMITH DO (NPI 1366337511) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since June 2025. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Jacob Gordon Smith Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 19
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
DETROIT, MI 48201
DETROIT, MI 48201
DETROIT, MI 48201
DETROIT, MI 48201
DETROIT, MI 48201
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jacob Smith's NPI number?
The NPI number for Jacob Smith is 1366337511. It was assigned to this individual provider in the NPPES registry on June 10, 2025.
Where is Jacob Smith located?
Jacob Smith practices at 4201 St Antoine Uhc-9c, Detroit, MI 48201. The listed phone number is (313) 745-5146.
What is Jacob Smith's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Jacob Smith enrolled in Medicare?
Yes. Jacob Smith is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Jacob Smith was last updated on June 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Jacob Gordon Smith, DO · NPI 1366337511
Student in an Organized Health Care Education/Training Program provider in Detroit, Michigan. Individual provider, active in the CMS NPPES registry since June 10, 2025.
## Identity
- **NPI:** 1366337511 (Entity type: Individual)
- **Enumerated:** June 10, 2025
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 4201 ST ANTOINE, UHC-9C, Detroit, MI 48201
- **Phone:** (313) 745-5146
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** June 18, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1366337511) · Data from the CMS NPPES public registry.