Individual provider Active NPI

Holly Lynn Smith, M.D.

  • Legal Medicine
  • Rural Retreat, VA
National Provider Identifier
1407804420
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
0101047615 Issued in VA
Practice address
306 South Main St.
Rural Retreat, VA 24368
Phone
(276) 686-5116
Fax
(276) 686-6289
NPI assigned
May 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X 0101047615 VA Primary

Addresses

Primary practice location

306 South Main St.
Rural Retreat, VA 24368

Mailing address

PO Box 753
Rural Retreat, VA 24368-0753
Phone (276) 686-5116

Other identifiers 1

IdentifierTypeStateIssuer
005667658MedicaidVA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101047615VAMDLegal Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wythe County Physician Practices LLC Past Accepting new patients
Rural Retreat Family Practice, LLC Legal Medicine Past Accepting new patients
Wythe County Physician Practices LLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407804420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 753",
            "city": "RURAL RETREAT",
            "state": "VA",
            "postal_code": "243680753",
            "telephone_number": "276-686-5116",
            "fax_number": "276-686-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 SOUTH MAIN ST.",
            "city": "RURAL RETREAT",
            "state": "VA",
            "postal_code": "24368",
            "telephone_number": "276-686-5116",
            "fax_number": "276-686-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "HOLLY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "VA",
            "license": "0101047615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005667658",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rural Retreat, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.