Individual provider Active NPI

Jacob Smith, DO

  • Emergency Medicine Physician
  • Roanoke, VA
National Provider Identifier
1659763290
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0102205716 Issued in VA
Practice address
1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone
(540) 981-7000
NPI assigned
Feb 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 0102205716 VA Primary

Addresses

Primary practice location

1906 Belleview Ave SE
Roanoke, VA 24014-1838

Mailing address

5100 W Broad St
Columbus, OH 43228-1607
Phone (614) 544-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jsmith128133@direct.carilionclinic.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200811002784 VA Practitioner - Emergency Medicine 1658647979 Reassigns benefits to 6 organizations
I20240909004690 WV Practitioner - Emergency Medicine 1658647979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, shared by 11 NPIs, 956 clinicians

Practice addresses (Care Compare)

1320 Maplewood Ave
Ronceverte, WV 24970-8016
Phone (304) 647-4411

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102205716VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Rockbridge Community Hospital CurrentSince Aug 2, 2020 Accepting new patients
Camc Greenbrier Valley Medical Center, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Carilion Giles Community Hospital CurrentSince Aug 2, 2020 Accepting new patients
Carilion Rockbridge Community Hospital CurrentSince Aug 2, 2020 Accepting new patients
Carilion Giles Community Hospital CurrentSince Aug 2, 2020 Accepting new patients
Carilion Medical Center CurrentSince Aug 10, 2022 Accepting new patients
Carilion Medical Center Emergency Medicine CurrentSince Aug 2, 2020 Accepting new patients
Carilion Giles Community Hospital Current Accepting new patients
Carilion Healthcare Corporation CurrentSince Jun 1, 2025 Accepting new patients
Carilion Healthcare Corporation CurrentSince Jun 1, 2025 Accepting new patients
Carilion Medical Center CurrentSince Aug 2, 2020 Accepting new patients
Camc Greenbrier Valley Medical Center Inc Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients
Carilion Emergency Services, Inc. CurrentSince Jun 1, 2025 Accepting new patients
Carilion Medical Center Past Accepting new patients

Locations

215 Gilbert St
Blacksburg, VA 24060
Phone (540) 961-8040

434 Peppers Fry Rd NW
Christiansburg, VA 24073
Phone (540) 382-6000

2900 Lamb Cir
Christiansburg, VA 24073
Phone (540) 731-2114

46 Wesley Rd
Daleville, VA 24083
Phone (540) 591-9440

13205 Booker T Washington Hwy
Hardy, VA 24101
Phone (540) 719-1815

1 Health Cir
Lexington, VA 24450
Phone (540) 458-3300

110 Houston St
Ste D
Lexington, VA 24450
Phone (540) 462-3950

159 Hartley Way
Pearisburg, VA 24134
Phone (540) 921-6000

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

4035 Electric Rd
Ste A
Roanoke, VA 24018
Phone (540) 772-8670

3 Riverside Cir
Roanoke, VA 24016

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

180 Floyd Ave
Rocky Mount, VA 24151
Phone (540) 483-5277

1935 W Main St
Salem, VA 24153
Phone (540) 302-0190

388 Ben Bolt Ave
Tazewell, VA 24651
Phone (276) 988-2506

400 Association Dr
Ste 102
Charleston, WV 25311
Phone (304) 388-1762

1521 Maplewood Ave
Ronceverte, WV 24970

1320 Maplewood Ave
Ronceverte, WV 24970
Phone (304) 645-0870

Interoperability endpoints

  • Direct secure messaging: jsmith113810@direct.carilionclinic.org

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1659763290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281607",
            "telephone_number": "614-544-1000",
            "fax_number": "614-544-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-981-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACOB",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-18",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102205716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsmith128133@direct.carilionclinic.org",
            "affiliation": "N",
            "endpointDescription": "jsmith128133@direct.carilionclinic.org",
            "address_1": "1906 Belleview Ave SE",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240141838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.