Individual provider Active NPI

Michael Q Smith, MD

  • Obstetrics & Gynecology Physician
  • Woodbridge, VA
National Provider Identifier
1053302513
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
0101044418 Issued in VA
Practice address
4379 Ridgewood Center Dr Ste 102
Woodbridge, VA 22192
Phone
(703) 680-7950
Fax
(703) 680-7953
NPI assigned
Nov 3, 2005
Last updated
Oct 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 0101044418 VA Primary

Addresses

Primary practice location

4379 Ridgewood Center Dr Ste 102
Woodbridge, VA 22192

Mailing address

4379 Ridgewood Center Dr Ste 102
Woodbridge, VA 22192-8323
Phone (703) 680-7950

Other practice location 1

1071 Care Way Ste 101
Fredericksburg, VA 22401-8431
Phone (540) 374-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20080312000506 VA Practitioner - Obstetrics/Gynecology 2769498252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of North Carolina at Chapel Hill School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3350 Commission CT
Woodbridge, VA 22192-1784
Phone 70368079505559

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Prince William Area Community Health Center Inc Current Accepting new patients
Greater Prince William Area Community Health Center Inc CurrentSince Oct 14, 2019 Accepting new patients
Greater Prince William Area Community Health Center Inc CurrentSince Oct 14, 2019 Accepting new patients

Locations

17739 Main St
Ste 130
Dumfries, VA 22026
Phone (703) 680-7950

9705 Liberia Ave
Ste 201
Manassas, VA 20110
Phone (703) 519-1725

3350 Commission Ct
Woodbridge, VA 22192
Phone (703) 680-7950

4379 Ridgewood Center Dr
Ste 102
Woodbridge, VA 22192
Phone (703) 680-7950

Interoperability endpoints

  • Direct secure messaging: michael.smith@gpwchc.eclinicaldirectplus.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1053302513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4379 RIDGEWOOD CENTER DR STE 102",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221928323",
            "telephone_number": "703-680-7950",
            "fax_number": "703-680-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4379 RIDGEWOOD CENTER DR STE 102",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22192",
            "telephone_number": "703-680-7950",
            "fax_number": "703-680-7953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1071 Care Way Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224018431",
            "country_code": "US",
            "telephone_number": "540-374-3100",
            "fax_number": "540-374-3102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAEL",
        "middle_name": "Q",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101044418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.