DAVID ALLEN SMITH (NPI# 1962405993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962405993 |
| Entity Type | Individual |
| Full Name | DAVID ALLEN SMITH |
| Credential | M.D. |
| Practice Address |
7613 W Jefferson Blvd Ste 200 Fort Wayne IN 46804-4182 |
| Practice Telephone | 2604697337 |
| Practice Fax Number | 2604697340 |
| Mailing Telephone | 2604697337 |
| Mailing Fax Number | 2604697340 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2014-03-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 01040403A | IN | Allopathic & Osteopathic Physicians |
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
01040403A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200049180 | 05 | |
| MI | 104683309 | 05 | |
| OH | 2080877 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629678438 | David B Smith | Pharmacist | 369 Scotts Fork-bonnie Road, Sutton, WV 26601 | 2020-10-30 |
| 1861028235 | David J Smith | Counselor | 841 Central Ave N # C114, Kent, WA 98032-2016 | 2020-03-18 |
| 1306470406 | David Smith | Counselor | 556 Harvick Cir, Stockbridge, GA 30281-4460 | 2020-02-27 |
| 1740811322 | David Smith | Student in an Organized Health Care Education/Training Program | 1620 Belvedere Pl, Round Rock, TX 78665-5658 | 2020-01-31 |
| 1407320880 | David Smith | Physical Therapist | 774 Christiana Rd Ste 3, Newark, DE 19713-4219 | 2019-01-18 |
| 1982177481 | David Culver Smith | Counselor | 15739 Tambour Ct, Chesterfield, MO 63017-7224 | 2019-01-07 |
| 1053895557 | David Wayne Smith Jr. | Pharmacist | 4651 S Custer Rd Apt 2203, Mckinney, TX 75070-8113 | 2018-09-20 |
| 1295212959 | David Kevin Smith | Technician/Technologist | 10041 Us Highway 19, Port Richey, FL 34668-3785 | 2018-07-25 |
| 1326540279 | David Crawford Smith | Internal Medicine | 3260 Adams Rd, Sacramento, CA 95864-5059 | 2018-03-07 |
| 1508370198 | David Shane Smith | Counselor | 2485 Maryville Dr, Dubuque, IA 52001-1663 | 2017-11-19 |
| Street Address |
7613 W JEFFERSON BLVD STE 200 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-4182 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265047138 | Josiah Wesley Reish | Nurse Practitioner | 7613 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804-4182 | 2020-09-09 |
| 1679891097 | Carey Lane Watson | Surgery | 7613 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804-4182 | 2010-05-10 |
| 1669455267 | Great Lakes Pediatric Surgeons, Inc. | Surgery | 7613 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804-4182 | 2005-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588664932 | Paul T. Stockmann | Surgery | 11123 Parkview Plaza Dr Ste 200, Fort Wayne, IN 46845-1707 | 2005-07-28 |
| 1528024783 | William A Loe Jr. | Surgery | 11123 Parkview Plaza Dr Ste 200, Fort Wayne, IN 46845 | 2006-04-25 |
| 1669455267 | Great Lakes Pediatric Surgeons, Inc. | Surgery | 7613 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804-4182 | 2005-11-29 |
| 1235111014 | Loretto Glynn | Surgery | 11115 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2005-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194081760 | Britney Lynne Grayson | Surgery | 8040 Clearvista Pkwy Ste 460, Indianapolis, IN 46256-4673 | 2012-04-07 |
| 1962592469 | Evan R. Kokoska | Surgery | 2001 W. 86th Street, Pediatric Hospital, Indianapolis, IN 46260 | 2006-10-13 |
| 1790880292 | Pediatric Surgical Associates Inc | Surgery | 250 N Shadeland Ave Ste 200, Indianapolis, IN 46219-4959 | 2006-09-13 |
| 1902833395 | Sunghoon Kim | Surgery | 8040 Clearvista Pkwy Ste 340, Indianapolis, IN 46256-4673 | 2006-06-28 |
| 1225464324 | Halkawt Ali Nuri | Surgery | 545 Barnhill Dr, Suite 215, Indianapolis, IN 46202-5112 | 2013-09-20 |
| 1184881641 | Jeremy Herrmann | Surgery | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2008-05-21 |
| 1548317431 | Matthew Landman | Surgery | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2007-01-04 |
| 1811066608 | Robert C Burns | Surgery | 705 Riley Hospital Dr, Ste 2500, Indianapolis, IN 46202-5109 | 2006-11-07 |
| 1699855304 | John W Brown | Surgery | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2006-10-17 |
| 1841393311 | Mark Rodefeld | Surgery | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2006-09-07 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
Please comment or provide details below to improve the information on DAVID ALLEN SMITH.
| 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.