Martin T Smith, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

0102050098 Issued in VA

Practice address

3825 Electric Rd Ste C
419 Office Center
Roanoke, VA 24018-4561

Phone

(540) 777-1711

Fax

(540) 777-1713

NPI assigned

Oct 6, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296604800000",
    "number": "1760470496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 MCVITTY FOREST DR",
            "address_2": "APT. 104",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183564",
            "telephone_number": "540-777-1711",
            "fax_number": "540-777-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 ELECTRIC RD STE C",
            "address_2": "419 OFFICE CENTER",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184561",
            "telephone_number": "540-777-1711",
            "fax_number": "540-777-1713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARTIN",
        "middle_name": "T",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2011-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "50098",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0102050098",
            "primary": true
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "VA",
            "license": "0102050098",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Nelson Smith, D.D.S.
• Lakisha Antoinette Smith
• Laura Lynn Smith, PHARMD
• Laura Marie Smith, RN
• Lisa Smith
• Micah Smith, PA-C
• Michael Douglas Clayton Smith, MD
• Parker Smith
• Paul Louis Smith, MSW
• Richard D Smith II, DDS

• Dermatology Physician in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; 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.