Individual provider Active NPI

Hermon W Smith III, MD

  • Pediatrics Physician
  • Baltimore, MD
National Provider Identifier
1043314214
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D36633 Issued in MD
Practice address
1000 E Eager Street
Baltimore, MD 21202
Phone
(410) 522-9800
Fax
(410) 522-9872
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D36633 MD Primary

Addresses

Primary practice location

1000 E Eager Street
Baltimore, MD 21202

Mailing address

3100 Wyman Park Drive
Suite 359a
Baltimore, MD 21211
Phone (410) 338-3016

Other identifiers 1

IdentifierTypeStateIssuer
525891000MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101202000982 MD Practitioner - Pediatric Medicine 4183811177 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians CurrentSince Aug 8, 2010 Accepting new patients
Johns Hopkins Community Physicians, Inc CurrentSince Aug 8, 2010 Accepting new patients
Johns Hopkins Community Physicians, Inc Pediatrics Current Accepting new patients
Johns Hopkins Community Physicians, Inc. Pediatrics Past Accepting new patients

Locations

1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800

3100 Wyman Park Dr
Ste 359A
Baltimore, MD 21211
Phone (410) 338-3016

Interoperability endpoints

  • Direct secure messaging: hsmith6861@direct.hopkinsmedicine.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322697600000",
    "number": "1043314214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 WYMAN PARK DRIVE",
            "address_2": "SUITE 359A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21211",
            "telephone_number": "410-338-3016",
            "fax_number": "410-338-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E EAGER STREET",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21202",
            "telephone_number": "410-522-9800",
            "fax_number": "410-522-9872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "HERMON",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2011-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D36633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "525891000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.