Organization Active NPI

Dr. Damaneon Smith and Associates PC

  • Podiatrist
  • Arlington, VA
National Provider Identifier
1033341383
Registry record updated Oct 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0103300902 Issued in VA
Legal business name
DR. DAMANEON SMITH AND ASSOCIATES PC
Practice address
5275 Lee Hwy Ste 303
Arlington, VA 22207-1619
Phone
(703) 538-5111
Fax
(703) 538-4193
NPI assigned
Aug 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Damaneon D Smith, DPMNPI 1457463663
Title
Owner
Phone
(703) 538-5111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 0103300902 VA Primary

Addresses

Primary practice location

5275 Lee Hwy Ste 303
Arlington, VA 22207-1619

Mailing address

5275 Lee Hwy Ste 303
Arlington, VA 22207-1619
Phone (703) 538-5111

Other identifiers 1

IdentifierTypeStateIssuer
1457463663MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091112000171 DC Part B Supplier - Clinic/Group Practice 0244378255 Receives reassigned benefits from 1 practitioner
Practice locations: Arlington, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288310400000",
    "number": "1033341383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5275 LEE HWY STE 303",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222071619",
            "telephone_number": "703-538-5111",
            "fax_number": "703-538-4193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5275 LEE HWY STE 303",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222071619",
            "telephone_number": "703-538-5111",
            "fax_number": "703-538-4193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. DAMANEON SMITH AND ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-20",
        "last_updated": "2010-10-29",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DAMANEON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-538-5111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103300902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457463663",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.