Active NPI
Dominic Joseph Smith
- Clinical Social Worker
- Landover, MD
National Provider Identifier
1316678006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 27358
- Practice address
- 903 Brightseat Rd
Landover, MD 20785-4725 - Phone
- (301) 333-2980
- NPI assigned
- Jun 22, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 27358 | MD | Primary |
Addresses
Primary practice location
903 Brightseat Rd
Landover, MD 20785-4725
Mailing address
Monroe 6782
Las Condes, SANTIAGO 7550000
CL
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27358 | Other | MD | MARYLAND BOARD OF SOCIAL WORK EXAMINERS |
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 |
|---|---|---|---|
| 27358 | MD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maryland Family Resource, 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Landover, MD
- NPI 1326189036
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655856000000",
"number": "1316678006",
"addresses": [
{
"country_code": "CL",
"country_name": "Chile",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "MONROE 6782",
"city": "LAS CONDES",
"state": "SANTIAGO",
"postal_code": "7550000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "903 BRIGHTSEAT RD",
"city": "LANDOVER",
"state": "MD",
"postal_code": "207854725",
"telephone_number": "301-333-2980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "DOMINIC",
"middle_name": "JOSEPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-22",
"last_updated": "2022-06-22",
"certification_date": "2022-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "27358",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MARYLAND BOARD OF SOCIAL WORK EXAMINERS",
"identifier": "27358",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Landover, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.