NPIMap

Individual provider Active NPI

David Middleton Smith, M.D.

  • Family Medicine Physician
  • Forest, VA
National Provider Identifier
1801887344
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101031023 Issued in VA
Practice address
2103 Graves Mill Rd
Forest, VA 24551-2675
Phone
(434) 316-7199
Fax
(434) 316-6185
NPI assigned
Nov 3, 2005
Last updated
Oct 22, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101031023 VA Primary

Addresses

Primary practice location

2103 Graves Mill Rd
Forest, VA 24551-2675

Mailing address

2103 Graves Mill Rd
Forest, VA 24551-2675
Phone (434) 316-7199

Other identifiers 7

IdentifierTypeStateIssuer
005613116MedicaidVA
5234699OtherVACIGNA
452132OtherVAANTHEM/BC/BS
0134585OtherVAUNITED HEALTHCARE
300825OtherVASOUTHERN HEALTH
080179876OtherVARAILROAD MEDICARE
541901162001OtherVAPCHP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100611000272 VA Practitioner - Family Practice 4688653801 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Virginia Commonwealth University, School of Medicine, 1978
Medicare assignment
May accept Medicare assignment
Group practices
Access Healthcare Multi-Specialty Group PLLCGroup PAC ID 4789922790, 5 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

2103 Graves Mill Rd
Forest, VA 24551-2675
Phone (434) 316-7199

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101031023VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Family Medicine CurrentSince Jan 31, 2017 Accepting new patients
Access Healthcare Multi-Specialty Group, PLLC CurrentSince Feb 1, 2019 Accepting new patients
Privia Medical Group, LLC CurrentSince Jan 31, 2017 Accepting new patients

Locations

2103 Graves Mill Rd
Forest, VA 24551
Phone (434) 316-7190

8644 Sudley Rd
#220
Manassas, VA 20110

Interoperability endpoints

  • Direct secure messaging: david.smith.1@18860.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/18860/brand/1/csg/1/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1801887344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 GRAVES MILL RD",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245512675",
            "telephone_number": "434-316-7199",
            "fax_number": "434-316-6185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 GRAVES MILL RD",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245512675",
            "telephone_number": "434-316-7199",
            "fax_number": "434-316-6185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DAVID",
        "middle_name": "MIDDLETON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101031023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005613116",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5234699",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM/BC/BS",
            "identifier": "452132",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0134585",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "300825",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080179876",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PCHP",
            "identifier": "541901162001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest, VA

Sources for this page

Verify at the official NPI Registry.