Active NPI
Roderick Malcolm Smith
- Private Vehicle
- Gate City, VA
National Provider Identifier
1124674163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- License
- T65017143
- Practice address
- 125 Fir St
Gate City, VA 24251-2926 - Phone
- (276) 690-8752
- Fax
- (276) 386-2465
- NPI assigned
- Aug 15, 2019
- Last updated
- Aug 15, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | T65017143 | VA | Primary |
Addresses
Primary practice location
125 Fir St
Gate City, VA 24251-2926
Mailing address
125 Fir St
Gate City, VA 24251-2926
Phone (276) 690-8752
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 |
|---|---|---|---|
| T65017143 | VA | MD | Private Vehicle |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565827200000",
"number": "1124674163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 FIR ST",
"city": "GATE CITY",
"state": "VA",
"postal_code": "242512926",
"telephone_number": "276-690-8752",
"fax_number": "276-386-2465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 FIR ST",
"city": "GATE CITY",
"state": "VA",
"postal_code": "242512926",
"telephone_number": "276-690-8752",
"fax_number": "276-386-2465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "RODERICK",
"middle_name": "MALCOLM",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-08-15",
"last_updated": "2019-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "VA",
"license": "T65017143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gate City, VA
- Katrina Rhenea Smith-Toole, ED.S/ M.ED
- Betty Kimbler Smith
- Kellie Dorton Smith
- Lester Earl Smith Sr.
- Lester Earl Smith Jr.
- Southwest Virginia Child Development Services
- Southwest Virginia Child Development Services Corp
- Templeton Dentistry, PC
- Therapy Innovations Inc (1St Step Rehab)
- Kayla Brooke Tiller, MS CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.