Roderic Smith, M.D., PH.D

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

MEDS4904 Issued in AK

Practice address

4315 Diplomacy Dr
Anchorage, AK 99508-5926

Phone

(907) 729-3300

NPI assigned

Mar 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AK, TX2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rsmith18820@ak.providencedirect.org
• Direct secure messaging: rsmith@direct.scf.cc

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.

• Alaska Native Tribal Health Consortium

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1437189339

  TX

  Medicare reassignment NPD
• Providence Health & Services- Washington

  dba Providence Medical Group Alaska

  • Critical Care Medicine (Internal Medicine) Physician
  • Anchorage, AK
  • NPI 1093956278
  Medicare reassignment NPD
• Southcentral Foundation

  dba BSD - McGrath

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • McGrath, AK
  • NPI 1780614263

  TX

  Medicare reassignment NPD
• Southcentral Foundation

  dba Alaska Subspecialty Pediatric Network (ASPN)

  • Multi-Specialty Clinic/Center
  • Wasilla, AK
  • NPI 1457196685
  NPD
• Southcentral Foundation

  dba BH 1115- KKGB CFDS

  • Community/Behavioral Health Agency
  • Anchorage, AK
  • NPI 1659924108
  NPD

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1952362170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7033 E TUDOR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071262",
            "telephone_number": "907-729-8901",
            "fax_number": "907-729-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 DIPLOMACY DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085926",
            "telephone_number": "907-729-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3340 Providence Dr",
            "address_2": "Suite A567",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995084691",
            "country_code": "US",
            "telephone_number": "907-212-2321",
            "fax_number": "907-212-8499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RODERIC",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "AK",
            "license": "MEDS4904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014588",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4654",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rsmith18820@ak.providencedirect.org",
            "affiliation": "N",
            "address_1": "3340 Providence Dr",
            "address_2": "Suite A567",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "995084691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rashanda Smith
• Rhonda Counselman Smith, DO
• Richard Stanley Smith Jr.
• Robert Eric Smith
• Robert Torrey Smith, N.D.
• Rosie Lee Smith
• Rukiyia Smith
• Russell Smith
• Samantha Paige Smith, PA-C, ATC
• Sarah L Smith, OTR/L

• Neurology with Special Qualifications in Child Neurology Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.