Clyde J. Smith III, M.D.

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

0101253870 Issued in VA

Practice address

1215 Lee St
Charlottesville, VA 22908-0816

Phone

(434) 924-1761

Fax

(434) 982-3561

NPI assigned

Jun 23, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: csmith210957@direct.healthsystem.virginia.edu

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.

• Childrens Specialty Group PLLC

  • Pediatrics Physician
  • Norfolk, VA
  • NPI 1255354130
  Medicare reassignment NPD
• University of Virginia Physicians Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Charlottesville, VA
  • NPI 1033138250
  Medicare reassignment NPD

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1881822302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-1761",
            "fax_number": "434-982-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CLYDE",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-23",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101253870",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101253870",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "VA",
            "license": "0101253870",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "VA",
            "license": "0101253870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csmith210957@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1215 Lee St",
            "city": "Charlottesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229080816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Austin Smith, MD
• Bailey Smith, RN
• Brooke S Smith, AG-ACNP
• Carleigh Smith, DNP, APRN, FNP-BC
• Carter D Smith, MD, DPT
• Courtney Howden Smith, FNP
• Craig Maxwell Smith, DO
• Donna Hartnett Smith, NP
• Elliot Z Smith, MD
• Erika R. Smith, PAC

• Pediatric Critical Care Medicine Physician in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Pediatric Critical Care Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.