David Lyman Smith, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G28351 Issued in CA

Practice address

500 Doyle Park Dr
Suite 100
Santa Rosa, CA 95405-4558

Phone

(707) 544-6090

Fax

(707) 544-2389

NPI assigned

Aug 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment
• Providence Medical Foundation

  • Obstetrics & Gynecology Physician
  • Napa, CA
  • NPI 1205131950
  NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1518070523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR",
            "address_2": "SUITE 100",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054558",
            "telephone_number": "707-544-6090",
            "fax_number": "707-544-2389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR",
            "address_2": "SUITE 100",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054558",
            "telephone_number": "707-544-6090",
            "fax_number": "707-544-2389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DAVID",
        "middle_name": "LYMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G28351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dsmith1658328@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "500 Doyle Park Dr",
            "address_2": "Suite 100",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954054558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Barry Smith, M.D.
• Briant W Smith, MD
• Brooke Smith
• Casey Josephine Smith, AU.D.
• Daniel P. Smith
• David Michael Smith
• Decker Wood Smith
• Douglas Kent Smith, PH.D.
• Elizabeth Ashley Smith, OTR/L, C/NDT
• Elizabeth Jane Smith, MA

• Pediatrics Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; 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.

Verify at the official NPI Registry.