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MR. JERRY SOLON SMITH PA-C
NPI 1578858742
Physician Assistant - Medical in Paducah, KY

Active since June 15, 2011PECOS Enrolled
4787 ALBEN BARKLEY DRIVE, PADUCAH, KY 42002(270) 442-9461(270) 441-0079 Get Directions Write a Review

NPPES record last updated: June 8, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mr. Jerry Solon Smith Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JERRY SOLON SMITH PA-C (NPI 1578858742) is an individual medical provider in Paducah, Kentucky, licensed in Kentucky (PA1645) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1578858742
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. JERRY SOLON SMITHCredential: PA-C
Location Address4787 ALBEN BARKLEY DRIVEPaducah, KY 42002
Mailing Address510 Lincoln DriveHerrin, IL 62948 · (618) 997-6800 · Fax (618) 997-1187
Phone(270) 442-9461
Fax(270) 441-0079
Sole ProprietorNo
Enumeration DateJune 15, 2011
Last NPPES UpdateJune 8, 2015
✔ NPI 1578858742 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in KY · PA1645
4787 ALBEN BARKLEY DRIVE, Paducah, KY 42002
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Other Identifiers 3

Medicare PINK003351KY
Medicare PINK003352KY
Medicaid7100226410KY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Jerry Solon Smith Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOUTHERN ORTHOPEDIC ASSOCIATES, S.C.
Orthopaedic Surgery
4787 ALBEN BARKLEY DRIVE
PADUCAH, KY 42002
McCracken County (270) 442-9461

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 Jerry Smith's NPI number?

The NPI number for Jerry Smith is 1578858742. It was assigned to this individual provider in the NPPES registry on June 15, 2011.

Where is Jerry Smith located?

Jerry Smith practices at 4787 Alben Barkley Drive, Paducah, KY 42002. The listed phone number is (270) 442-9461.

What is Jerry Smith's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Jerry Smith enrolled in Medicare?

Yes. Jerry Smith is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jerry Smith was last updated on June 8, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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.