Active NPI
David C Smith, DO
- Emergency Medicine Physician
- West Burlington, IA
National Provider Identifier
1689656241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 03233
- Practice address
- 1221 S Gear Ave
West Burlington, IA 52655-1679 - Phone
- (319) 768-3628
- Fax
- (319) 768-3633
- NPI assigned
- Nov 18, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 03233 | IA | Primary |
Addresses
Primary practice location
1221 S Gear Ave
West Burlington, IA 52655-1679
Mailing address
1221 S Gear Ave
West Burlington, IA 52655-1679
Phone (319) 768-1000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0193946 | Medicaid | IA | |
| 930097500 | Other | IA | RR MC |
| 09665 | Other | IA | BX |
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 Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Iowa Regional Medical Center, Inc. | Past | Accepting new patients | |
| Southeast Iowa Regional Medical Center, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community Based Hospice Care Agency
- West Burlington, IA
- NPI 1053315002
-
- General Practice Physician
- West Burlington, IA
- NPI 1164433884
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256601600000",
"number": "1689656241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 S GEAR AVE",
"city": "WEST BURLINGTON",
"state": "IA",
"postal_code": "526551679",
"telephone_number": "319-768-1000",
"fax_number": "319-768-4728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 S GEAR AVE",
"city": "WEST BURLINGTON",
"state": "IA",
"postal_code": "526551679",
"telephone_number": "319-768-3628",
"fax_number": "319-768-3633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "DAVID",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-18",
"last_updated": "2009-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IA",
"license": "03233",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0193946",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MC",
"identifier": "930097500",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BX",
"identifier": "09665",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Burlington, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.