Colleen Ewing Smith

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

0803000302 Issued in VA

Practice address

40 Douglas Ave NW
Roanoke, VA 24012-4611

Phone

(540) 852-2502

NPI assigned

Feb 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Colleen Diane Ewing Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Roanoke City Public Schools

  • Local Education Agency (LEA)
  • Roanoke, VA
  • NPI 1154348985
  NPD (past)

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1700387404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 DOUGLAS AVE NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240124611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 DOUGLAS AVE NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240124611",
            "telephone_number": "540-852-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "COLLEEN",
        "middle_name": "EWING",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-27",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "VA",
            "license": "0803000302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0813000761",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "EWING",
            "middle_name": "DIANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexa Smith
• Anthony Grainger Smith, PT
• Benjamin Smith
• Cassandra Smith
• Cody Fabian Smith, MD
• Daniel Smith, MD
• Debbie C. Smith, LCSW
• Donald Smith Jr., MD
• Erik Thomas Smith, D.P.T.
• George Landon Smith, M.D.

• School Psychologist in Roanoke, VA
• Providers in Roanoke, VA by specialty
• School Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; 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.