Individual provider Active NPI

Wyatt S Smith, D.O.

  • Anatomic Pathology & Clinical Pathology Physician
  • Bethesda, MD
National Provider Identifier
1124187448
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
20A 5297 Issued in CA
Practice address
8901 Rockville Pike
Bethesda, MD 20889-5600
Phone
(301) 295-4810
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 20A 5297 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 20A 5297 CA Primary

Addresses

Primary practice location

8901 Rockville Pike
Bethesda, MD 20889-5600

Mailing address

6759 Bronze Post Rd
Centreville, VA 20121-2189
Phone (703) 222-8807

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
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A 5297CAMDHematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1124187448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6759 BRONZE POST RD",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212189",
            "telephone_number": "703-222-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 ROCKVILLE PIKE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208895600",
            "telephone_number": "301-295-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WYATT",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "20A 5297",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "20A 5297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.