Individual provider Active NPI

Morgan Smith, LAT, ATC

  • Sports Medicine (Preventive Medicine) Physician
  • Mechanicsville, VA
National Provider Identifier
1629563242
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Preventive Medicine) PhysicianTaxonomy code 2083S0010X
License
0126003001 Issued in VA
Practice address
8200 Meadowbridge Rd Ste 200
Mechanicsville, VA 23116-2337
Phone
(804) 730-2121
NPI assigned
Jun 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Preventive Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2083S0010X 0126003001 VA Primary

Addresses

Primary practice location

8200 Meadowbridge Rd Ste 200
Mechanicsville, VA 23116-2337

Mailing address

75 Fern Oak Cir Apt 201
Stafford, VA 22554-8459
Phone (301) 775-1552

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

LicenseStateTypeSpecialty
0126003001VAMDSports Medicine (Preventive Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1629563242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FERN OAK CIR APT 201",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225548459",
            "telephone_number": "301-775-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 MEADOWBRIDGE RD STE 200",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231162337",
            "telephone_number": "804-730-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MORGAN",
        "name_prefix": "Ms.",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083S0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": "VA",
            "license": "0126003001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.