Active NPI
Colin Lucas Smith, DO
- Family Medicine Physician
- Williamsburg, VA
National Provider Identifier
1457041469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0102210239
- Practice address
- 113 Sanda Ave
Williamsburg, VA 23185-5830 - Phone
- (757) 887-7639
- NPI assigned
- May 11, 2023
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0102210239 | VA | Primary |
| Family Medicine Physician | 207Q00000X | OS21342 | FL | |
| Military Health Care Provider | 171000000X |
Addresses
Primary practice location
113 Sanda Ave
Williamsburg, VA 23185-5830
Mailing address
113 Sanda Ave
Williamsburg, VA 23185-5830
Other practice location 1
2080 Child Street
Jacksonville, FL 32214
Phone (904) 542-7300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240822004779 | FL | Order and Referring Only - Family Practice | 7810436722 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS21342 | FL | MD | General Practice Physician |
Interoperability endpoints
- csmith712260@direct.shands.ufl.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785283200000",
"number": "1457041469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 SANDA AVE",
"city": "WILLIAMSBURG",
"state": "VA",
"postal_code": "231855830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 SANDA AVE",
"city": "WILLIAMSBURG",
"state": "VA",
"postal_code": "231855830",
"telephone_number": "757-887-7639"
}
],
"practiceLocations": [
{
"address_1": "2080 Child Street",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "32214",
"country_code": "US",
"telephone_number": "904-542-7300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "COLIN",
"middle_name": "LUCAS",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-11",
"last_updated": "2026-07-29",
"certification_date": "2026-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VA",
"license": "0102210239",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "OS21342",
"primary": false
},
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williamsburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.