Individual provider Active NPI

Judith Ann Smith, PSY.D.

  • Clinical Psychologist
  • Silver Spring, MD
National Provider Identifier
1811262942
Registry record updated Mar 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS009140L Issued in PA
Practice address
8901 New Hampshire Ave
Silver Spring, MD 20903-3611
Phone
(301) 422-5444
NPI assigned
Mar 22, 2012
Last updated
Mar 22, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS009140L PA Primary

Addresses

Primary practice location

8901 New Hampshire Ave
Silver Spring, MD 20903-3611

Mailing address

1510 Heather Hollow Cir
# 21
Silver Spring, MD 20904-2374
Phone (301) 328-5112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121203000352 PA Practitioner - Clinical Psychologist 7911159694 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Villa St John Vianney CurrentSince Aug 4, 2020 Accepting new patients
Catholic Clinical Consultants CurrentSince Oct 1, 2012 Accepting new patients

Locations

151 Woodbine Rd
Downingtown, PA 19335
Phone (610) 269-2600

100 Levittown Pkwy
Levittown, PA 19054
Phone (215) 945-2550

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332374400000",
    "number": "1811262942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 HEATHER HOLLOW CIR",
            "address_2": "# 21",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042374",
            "telephone_number": "301-328-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 NEW HAMPSHIRE AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209033611",
            "telephone_number": "301-422-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JUDITH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-22",
        "last_updated": "2012-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS009140L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.