Active NPI
SMDS LLC
- Family Medicine Physician
- Potomac Falls, VA
National Provider Identifier
1891424123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- SMDS LLC
- Practice address
- 20535 Earhart PL
Potomac Falls, VA 20165-3581 - Phone
- (248) 736-3561
- NPI assigned
- Jun 10, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Krystle Brown
- Title
- Billing Manager
- Phone
- (410) 800-6251
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
20535 Earhart PL
Potomac Falls, VA 20165-3581
Mailing address
522 Red Raspberry Ter
Leesburg, VA 20175-5427
Phone (248) 736-3561
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
20535 Earhart Pl
Sterling, VA 20165
Phone (703) 404-5205
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654819200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1654819200000",
"number": "1891424123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "522 RED RASPBERRY TER",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201755427",
"telephone_number": "248-736-3561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20535 EARHART PL",
"city": "POTOMAC FALLS",
"state": "VA",
"postal_code": "201653581",
"telephone_number": "248-736-3561"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SMDS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-06-10",
"last_updated": "2022-06-10",
"certification_date": "2022-06-10",
"status": "A",
"authorized_official_last_name": "BROWN",
"authorized_official_first_name": "KRYSTLE",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "410-800-6251",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Potomac Falls, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.