Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Daniel Jackson Smith, PHD, AGPCNP-BC, CNE

Individual provider Registered Nurse · NPI 1902556848

Dr. Daniel Jackson Smith, PHD, AGPCNP-BC, CNE is a Nurse Practitioner in Buffalo, New York. Qualified in 2021, 5 years ago. Practices with Jericho Road Ministries, Inc, a 33-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Georgia, New York and Pennsylvania.

Years since qualifying
5
Licensed in
GA, NY, PA
In the registry since
2022
Specialties on file
5
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

100 E Tupper St
Buffalo, NY 14203-1315
Phone: (716) 919-6870
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1520 Clifton Rd Ne, Atlanta, GA 30322-4201 — (404) 727-7980
  • 301b Wende Hall, Buffalo, NY 14214-8013 — (716) 829-6066

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 311879 (NY)
Registered Nurse Taxonomy 163W00000X · Licence RN749716 (PA)
Registered Nurse Taxonomy 163W00000X · Licence RN280809 (GA)
Nurse Practitioner Taxonomy 363L00000X · Licence RN280809 (GA)
Nurse Practitioner Taxonomy 363L00000X · Licence SP025728 (PA)

Record details

NPI number1902556848
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD , AGPCNP-BC , CNE
Sole proprietorNo
NPI enumeratedMarch 24, 2022
Last updated in NPPESOctober 4, 2024
Certification dateOctober 4, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Jericho Road Ministries, Inc. — 33 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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