Shane David Smith, M.D

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

D0096028 Issued in MD

Practice address

810 Landmark Dr Ste 217-219
Glen Burnie, MD 21061-4987

Phone

(443) 351-3376

NPI assigned

May 25, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, MD, DC3 enrollments

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 3

Specialty

Pathology

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anne Arundel Dermatology PAGroup PAC ID 6608761960, 126 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Anne Arundel Dermatology LLC

  • Dermatology Physician
  • Annapolis, MD
  • NPI 1063481703

  DC

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1124476676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 CONCOURSE DR STE 201",
            "city": "LINTHICUM HEIGHTS",
            "state": "MD",
            "postal_code": "210901033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 LANDMARK DR STE 217-219",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614987",
            "telephone_number": "443-351-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHANE",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-25",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D0096028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Smith, PA-C
• Laura Smith, NP
• Leah Michelle Smith, RN
• Melissa Smith
• Rae Christy Smith, PHARM.D
• Sharon Smith, LMSW
• Stacey Renee Smith
• Teresa Marie Smithson
• Sarah Snead, HEALTH EDUCATOR
• Emily Snellings, LCSW-C

• Dermatology Physician in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Dermatology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.