PHILIP SMITH (NPI# 1780608984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780608984 |
| Entity Type | Individual |
| Full Name | PHILIP SMITH |
| Credential | M.D. |
| Practice Address |
8221 Willow Oaks Corporate Dr Fairfax VA 22031-4512 |
| Practice Telephone | 7032077818 |
| Practice Fax Number | 7036536692 |
| Mailing Telephone | 7032077818 |
| Mailing Fax Number | 7036536692 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2016-12-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MD034477 | DC | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
0101058192 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MEDICAL LICENSE | 0101058192 | 01 |
| DC | MEDICAL LICENSE | MD034477 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043626351 | Philip James Smith | Pharmacist | 2591 E M-21, Coronna, MI 48817 | 2014-07-08 |
| 1205023769 | Philip Allen Smith | Physician Assistant | 1 Air National Guard Rd, Scotia, NY 12302 | 2007-09-28 |
| 1952351876 | Philip Michael Smith | Ophthalmology | 3211 Fortune Ct, Suite A, Auburn, CA 95602-9245 | 2006-05-11 |
| 1003815440 | Philip Sheridan Smith | Internal Medicine | 164 Willow Ave, Cornwall, NY 12518-1329 | 2005-07-19 |
| 1942206149 | Philip C Smith | Ophthalmology | 401 Baptist Dr Ste 201, Madison, MS 39110 | 2005-06-22 |
| 1184124828 | Philip Michael Smith | Behavior Technician | 5820 Stoneridge Mall Rd Ste 205, Pleasanton, CA 94588-3347 | 2018-02-20 |
| 1649793597 | Philip Brian Smith | Pharmacist | 7000 E Broad St, Columbus, OH 43213-1519 | 2017-07-24 |
| 1932583598 | Philip Smith | Student in an Organized Health Care Education/Training Program | 9808 Venice Blvd, Ste. 505, Culver City, CA 90232-2732 | 2015-07-14 |
| 1609280809 | Philip Smith | Counselor | 5982 Rhodes Rd, Kent, OH 44240-8100 | 2014-06-16 |
| 1992116842 | Philip Nathaniel Smith | Radiology | 801 S Stevens St, Spokane, WA 99204-2654 | 2014-05-14 |
| Street Address |
8221 WILLOW OAKS CORPORATE DR |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22031-4512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051102 | Elizabeth Christensen | Registered Nurse | 8221 Willow Oaks Corporate Dr, Fairfax, VA 22031-4512 | 2020-10-23 |
| 1255939955 | Alyssa Grace Honesty | Registered Nurse | 8221 Willow Oaks Corporate Dr, Fairfax, VA 22031-4512 | 2020-10-14 |
| 1457958977 | Jennifer Hugel | Social Worker | 8221 Willow Oaks Corporate Dr, Fairfax, VA 22031-4512 | 2020-10-07 |
| 1407453442 | Vilma Gisell Gaitan Valdizan | Counselor | 8221 Willow Oaks Corporate Dr, Fairfax, VA 22031-4512 | 2020-10-02 |
| 1568073476 | Sarah Elizabeth Davis | Counselor | 8221 Willow Oaks Corporate Dr, Fairfax, VA 22031-4512 | 2020-08-13 |
| 1356959118 | Irina Rasner | Social Worker | 8221 Willow Oaks Corporate Dr, Fairfax, VA 22031-4512 | 2020-07-17 |
| 1316565062 | Adrienne Terese Iannazzo | Counselor | 8221 Willow Oaks Corporate Dr, Fairfax, VA 22031-4512 | 2020-07-09 |
| 1184249112 | Leemon Chenteau Hoyle Jr. | Counselor | 8221 Willow Oaks Corporate Dr, Fairfax, VA 22031-4512 | 2020-06-16 |
| 1528681160 | Colleen Ebel | Counselor | 8221 Willow Oaks Corporate Dr, Fairfax, VA 22031-4512 | 2020-05-18 |
| 1205456126 | Mary Moussa | Counselor | 8221 Willow Oaks Corporate Dr, Fairfax, VA 22031-4512 | 2020-04-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902414105 | Su Jung Kang | Dentist | 9661-c Main Street, Fairfax, VA 22031 | 2020-07-14 |
| 1346896347 | Fuling Guo | Acupuncturist | 3013 James St, Fairfax, VA 22031 | 2019-08-15 |
| 1902458797 | Kayla Callister | Psychologist | 2270 Willow Oaks Corporate Drive, Fairfax, VA 22031 | 2019-07-11 |
| 1790349801 | Fairfax Dental Esthetics | Dentist | 9621 Fairfax Blvd., Fairfax, VA 22031 | 2019-04-24 |
| 1417427675 | Kathryn Yen Ho | Speech-Language Pathologist | 8270 Willow Oaks Corporate Drive Suite 2127, Falls Church, VA 22031 | 2018-11-30 |
| 1932681376 | Joanne Towers | Physician Assistant | 3025 Hamaker Court Suite 300, Fairfax, VA 22031 | 2018-09-01 |
| 1790262020 | S Renee Dennis | Nurse Practitioner | 8316 Arlington Blvd Ste 500, Fairfax, VA 22031 | 2018-07-19 |
| 1013493451 | Elizabeth Joan Dwyer | Physician Assistant | 3023 Hamaker Ct., Suite 500, Fairfax, VA 22031 | 2018-07-18 |
| 1316432669 | Delta Pharm LLC | Pharmacy | 8316 Arlington Blvd Ste 100, Fairfax, VA 22031 | 2018-06-28 |
| 1629567656 | Laura Breeden | Acupuncturist | 3846 Lyndhurst Dr Apt 301, Fairfax, Va, VA 22031 | 2018-05-04 |
| Find all providers in zip 22031 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114007077 | Elizabeth Maier Reynolds | Psychiatry & Neurology | 12801 Hamlet Hill Way, Fairfax, VA 22030-7250 | 2006-10-16 |
| 1083959373 | Ravinderpal Singh | Psychiatry & Neurology | 11204 Waples Mill Rd, Fairfax, VA 22030-6036 | 2012-11-28 |
| 1750641668 | Vikas Mangewala | Psychiatry & Neurology | 3930 Pender Dr Ste 350, Fairfax, VA 22030-0989 | 2012-05-24 |
| 1740332519 | Lorency Fernando | Psychiatry & Neurology | 11204 Waples Mill Rd, Fairfax, VA 22030-6048 | 2007-01-18 |
| 1740343672 | Peter Howard Robbins | Psychiatry & Neurology | 3959 Pender Dr, #320, Fairfax, VA 22030-6041 | 2006-12-19 |
| 1780773754 | Elizabeth Lathrop Finch | Psychiatry & Neurology | 10470 Armstrong St, Fairfax, VA 22030-3648 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902248073 | Tanvir Iqbal | Psychiatry & Neurology | 201 S Main St Ste 3400, Danville, VA 24541-2932 | 2013-07-18 |
| 1821364043 | Michael Kubelik Heck | Psychiatry & Neurology | 691 Berkmar Cir, Charlottesville, VA 22901-1464 | 2012-04-02 |
| 1831403864 | Neel Nene | Psychiatry & Neurology | 801 N Quincy St Ste 601, Arlington, VA 22203-1729 | 2010-08-02 |
| 1295048684 | My Psychiatrist, Plc | Psychiatry & Neurology | 12359 Sunrise Valley Dr Ste 320, Herndon, VA 20191-3463 | 2010-07-14 |
| 1023257979 | Kevin Michael Williams | Psychiatry & Neurology | 3737 Seminary Rd, Alexandria, VA 22304-5202 | 2009-02-17 |
| 1881854982 | John Paul Steg | Psychiatry & Neurology | 6760 Old Mclean Village Dr, Mc Lean, VA 22101-3906 | 2008-06-11 |
| 1336343516 | Nelson Lugo | Psychiatry & Neurology | 43330 Junction Plz Ste 160, Pmb 108, Ashburn, VA 20147-3408 | 2007-06-12 |
| 1598973471 | Charles E Hall Iv | Psychiatry & Neurology | 100 Boulders Pkwy, Suite 202, Richmond, VA 23225 | 2007-05-21 |
| 1699983692 | Heather Kilbride Henig | Psychiatry & Neurology | 11490 Commerce Park Dr Ste 420, Reston, VA 20191 | 2007-05-21 |
| 1104942754 | William Louis Licamele | Psychiatry & Neurology | 6760 Old Mclean Village Dr., Mclean, VA 22101-3906 | 2007-03-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.