Active NPI
Daniel Lee Smith, MD
- Emergency Medicine Physician
- Cross Lanes, WV
National Provider Identifier
1962466979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 14012
- Practice address
- 314 Goff Mountain Rd
Cross Lanes, WV 25313-6602 - Phone
- (304) 388-7070
- Fax
- (304) 388-7075
- NPI assigned
- Apr 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 14012 | WV | |
| Emergency Medicine Physician | 207P00000X | 14012 | WV | Primary |
Addresses
Primary practice location
314 Goff Mountain Rd
Cross Lanes, WV 25313-6602
Mailing address
415 Morris St
Suite 304
Charleston, WV 25301-1842
Phone (304) 388-7783
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 930063433 | Other | RAILROAD MEDICARE | |
| 0051744-000 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14012 | WV | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Health Care Providers | Past | Accepting new patients | |
| Charleston Area Medical Center Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Charleston, WV
- NPI 1922123587
-
- Multi-Specialty Clinic/Center
- Belpre, OH
- NPI 1588422547
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354665600000",
"number": "1962466979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 MORRIS ST",
"address_2": "SUITE 304",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253011842",
"telephone_number": "304-388-7783",
"fax_number": "304-388-7788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "314 GOFF MOUNTAIN RD",
"city": "CROSS LANES",
"state": "WV",
"postal_code": "253136602",
"telephone_number": "304-388-7070",
"fax_number": "304-388-7075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "DANIEL",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-14",
"last_updated": "2012-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WV",
"license": "14012",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WV",
"license": "14012",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "930063433",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0051744-000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cross Lanes, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.