Victor Dimetri Smith

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

180456 Issued in CA

Practice address

2424 City Hall LN
North Charleston, SC 29406-6538

Phone

(843) 577-5011

NPI assigned

Apr 3, 2018

Last updated

Oct 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• High Desert Nephrology Associates PLLC

  dba High Desert Nephrology Assoc

  • Nephrology Physician
  • Gallup, NM
  • NPI 1144482860
  NPD (past)
• Red Rocks Dialysis, LLC

  dba U.S Renal Care Gallup PD Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Gallup, NM
  • NPI 1780915298
  NPD (past)

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1376049890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 BRANDIMERE DR",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308132808",
            "telephone_number": "706-421-7592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 CITY HALL LN",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294066538",
            "telephone_number": "843-577-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "VICTOR",
        "middle_name": "DIMETRI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "12414",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "X-10412",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "180456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Narlin Smith, APRN FNP-C, PMHNP-BC
• Rosa B. Smith, LISW-CP
• Stephen Smith, PA
• Sydney C Smith
• Tammy L Smith, LPN
• Gina Snell, RN
• John Snyder, DPT
• Todd Louis Snyder, MD
• Hanan Sokol, ATC
• Grace Song, MD

• Clinical Social Worker in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.