Individual provider Active NPI

Christopher David Van Smith, D.O.

  • Emergency Medicine Physician
  • Miramar, FL
National Provider Identifier
1891723003
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS9487 Issued in FL
Practice address
1901 SW 172ND Ave
Miramar, FL 33029-5592
Phone
(954) 538-5000
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS9487 FL Primary

Addresses

Primary practice location

1901 SW 172ND Ave
Miramar, FL 33029-5592

Mailing address

14050 NW 14TH St
Suite 190
Sunrise, FL 33323-2865
Phone (800) 424-3672

Other identifiers 1

IdentifierTypeStateIssuer
16173OtherFLBLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20050829000640 FL Practitioner - Emergency Medicine 2062443161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Emergency Medicine of Broward LLCGroup PAC ID 5991793002, 69 clinicians

Practice addresses (Care Compare)

3000 Coral Hills Dr
Coral Springs, FL 33065-4108
Phone (954) 939-5000

Hospital & facility affiliations

  • Broward Health Medical Center Hospital, Fort Lauderdale, FL, CCN 100039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS9487FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Emergency Medicine of Broward LLC Emergency Medicine CurrentSince Nov 3, 2009 Accepting new patients
Phoenix Emergency Medicine of Broward LLC Emergency Medicine CurrentSince Nov 3, 2009 Accepting new patients
Inphynet South Broward LLC Emergency Medicine Past Accepting new patients

Locations

201 E Sample Rd
Deerfield Beach, FL 33064
Phone (954) 786-6400

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1891723003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14050 NW 14TH ST",
            "address_2": "SUITE 190",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232865",
            "telephone_number": "800-424-3672",
            "fax_number": "954-377-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 SW 172ND AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330295592",
            "telephone_number": "954-538-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN SMITH",
        "first_name": "CHRISTOPHER",
        "middle_name": "DAVID",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS9487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "16173",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.