Individual provider Active NPI

David Vernon Smith, M.D.

  • Pediatric Sports Medicine Physician
  • Norfolk, VA
National Provider Identifier
1164588331
Registry record updated Oct 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X
License
0101248738 Issued in VA
Practice address
601 Childrens LN
Norfolk, VA 23507-1910
Phone
(757) 668-7529
Fax
(757) 668-7885
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Sports Medicine Physician 2080S0010X 0101248738 VA Primary
Pediatrics Physician 208000000X 0101248738 VA

Addresses

Primary practice location

601 Childrens LN
Norfolk, VA 23507-1910

Mailing address

601 Childrens LN
Norfolk, VA 23507-1910
Phone (757) 668-7529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110610000005 VA Practitioner - Sports MedicinePractitioner - Pediatric Medicine 2668665621 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101248738VAMDPediatric Sports Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Specialty Group PLLC Pediatrics CurrentSince Jul 1, 2011 Accepting new patients

Locations

500 Discovery Dr
Chesapeake, VA 23320
Phone (757) 668-2311

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

171 Kempsville Rd
Bldg A
Norfolk, VA 23502
Phone (757) 668-6550

1924 Landstown Centre Way
Virginia Beach, VA 23456
Phone (757) 668-4673

3960 Virginia Beach Blvd
Virginia Beach, VA 23452
Phone (757) 668-4648

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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382313600000",
    "number": "1164588331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 CHILDRENS LN",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071910",
            "telephone_number": "757-668-7529",
            "fax_number": "757-668-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CHILDRENS LN",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071910",
            "telephone_number": "757-668-7529",
            "fax_number": "757-668-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DAVID",
        "middle_name": "VERNON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2013-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "VA",
            "license": "0101248738",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101248738",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.