Individual provider Active NPI

Lisa Smirnow, D.O.

  • Family Medicine Physician
  • Eldersburg, MD
National Provider Identifier
1114965571
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H0037356 Issued in MD
Practice address
1380 Progress Way
Suite112
Eldersburg, MD 21784-6464
Phone
(410) 549-2000
NPI assigned
Jun 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H0037356 MD Primary

Addresses

Primary practice location

1380 Progress Way
Suite112
Eldersburg, MD 21784-6464

Mailing address

1380 Progress Way
Suite112
Eldersburg, MD 21784-6464
Phone (410) 549-2000

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
H0037356MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 1

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1114965571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 PROGRESS WAY",
            "address_2": "SUITE112",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846464",
            "telephone_number": "410-549-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 PROGRESS WAY",
            "address_2": "SUITE112",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846464",
            "telephone_number": "410-549-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMIRNOW",
        "first_name": "LISA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "H0037356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.