DR. RODERIC SMITH (NPI# 1952362170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952362170 |
| Entity Type | Individual |
| Full Name | DR. RODERIC SMITH |
| Credential | M.D., PH.D |
| Practice Address |
3340 Providence Dr Suite A567 Anchorage AK 99508-4691 |
| Mailing Address |
Po Box 231735 Anchorage AK 99523-1735 |
| Practice Telephone | 9072122321 |
| Practice Fax Number | 9072128499 |
| Mailing Telephone | 9076321496 |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2020-10-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
4904 | AK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | 4654 | 05 | |
| AK | 1014588 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811920663 | Roderic A Smith | Family Medicine | 1921 Stonecipher Blvd, Ada, OK 74820 | 2006-07-07 |
| Street Address |
3340 PROVIDENCE DR SUITE A567 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-4691 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992706865 | Evelyn D Rider | Pediatrics | 3340 Providence Dr, Suite 366, Anchorage, AK 99508-4616 | 2005-08-02 |
| 1265967137 | Providence Imaging Center | Clinic/Center | 3340 Providence Dr, Anchorage, AK 99508 | 2017-04-27 |
| 1053844019 | Stephanie S Fortt | Social Worker | 3340 Providence Dr, Suite A351, Anchorage, AK 99508-4691 | 2017-04-06 |
| 1407306434 | Haven Medical, LLC | Physician Assistant | 3340 Providence Dr, Ste 466, Anchorage, AK 99508-4691 | 2016-10-13 |
| 1962952234 | Megan Hurlburt | Dietitian, Registered | 3340 Providence Dr, Suite 358, Anchorage, AK 99508-4691 | 2016-10-10 |
| 1770968158 | Zachary Johnson | Physician Assistant | 3340 Providence Dr, Suite #a565, Anchorage, AK 99508-4691 | 2015-07-27 |
| 1235478553 | Jessica H Anderson | Physician Assistant | 3340 Providence Dr, Suite 565, Anchorage, AK 99508-4691 | 2013-02-06 |
| 1104174275 | Nicole Kopacz | Nurse Practitioner | 3340 Providence Dr, Suite 452, Anchorage, AK 99508-4691 | 2012-08-21 |
| 1922372598 | Northern Lights Surgical Associates, P.C. | Specialist | 3340 Providence Dr, Suite 363, Anchorage, AK 99508-4691 | 2012-02-29 |
| 1831480151 | Todd Alan Sneesby | Dentist | 3340 Providence Dr, Suite 560, Anchorage, AK 99508-4627 | 2011-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early 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 |
|---|---|---|---|---|
| 1437384583 | Irisa Melita Pakalns Devine | Psychiatry & Neurology | 3340 Providence Dr Ste A-565, Anchorage, AK 99508-4691 | 2009-05-19 |
| 1598823205 | Aaron Johnson | Psychiatry & Neurology | 3200 Providence Dr, Suite 248- Pamc Sleep Disorders Center, Anchorage, AK 99508-4615 | 2006-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629369640 | Dorlyne Michelle Brchan | Psychiatry & Neurology | 1001 Noble St, Fairbanks, AK 99701-4948 | 2011-04-25 |
Please comment or provide details below to improve the information on DR. RODERIC 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.