Active NPI
Diane Ruth Smith
- Adult Health Nurse Practitioner
- Bolling Afb, DC
National Provider Identifier
1073591285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 0001040494
- Practice address
- 238 Brookley Ave.
Bolling Afb, DC 20332-0001 - Phone
- (202) 404-3603
- NPI assigned
- Jan 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 0001040494 | VA | Primary |
Addresses
Primary practice location
238 Brookley Ave.
Bolling Afb, DC 20332-0001
Mailing address
1016 S Wayne St
#612
Arlington, VA 22204-4433
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0001040494 | VA | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1073591285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1016 S WAYNE ST",
"address_2": "#612",
"city": "ARLINGTON",
"state": "VA",
"postal_code": "222044433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "238 BROOKLEY AVE.",
"city": "BOLLING AFB",
"state": "DC",
"postal_code": "203320001",
"telephone_number": "202-404-3603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "DIANE",
"middle_name": "RUTH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-06",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "VA",
"license": "0001040494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bolling Afb, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.