Baxter J. Smith Jr., OD, PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

858 Issued in NC

Legal business name

BAXTER J. SMITH JR., OD, PA

Doing business as

HealthDrive Eye Care Group

Practice address

5960 Fairview Rd Ste 300
Charlotte, NC 28210-0202

Phone

(888) 964-6681

Fax

(888) 662-0859

NPI assigned

Jun 17, 2007

Last updated

Jul 14, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Baxter J. Smith Jr., ODNPI 1689750648

Title

President

Phone

(857) 255-0486

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• HealthDrive Eye Care Group Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sarit G. Catchatoorian, O.D.

  • Optometrist
  • Charlotte, NC
  • NPI 1720190333
  Medicare reassignment Care Compare group NPD
• Nicole Marie Gordon, OD

  • Optometrist
  • Raleigh, NC
  • NPI 1588974224
  Medicare reassignment Care Compare group NPD
• Donald Robin Macqueen, O.D.

  • Optometrist
  • Charlotte, NC
  • NPI 1740330539
  Medicare reassignment Care Compare group NPD
• Baxter J Smith Jr., OD

  • Optometrist
  • Charlotte, NC
  • NPI 1689750648
  Medicare reassignment NPD Authorized official
• Eyra Aku Tamakloe, OD

  • Optometrist
  • Charlotte, NC
  • NPI 1922670876
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1182038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626220800000",
    "number": "1003011446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CROSSING BLVD STE 300",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017025555",
            "telephone_number": "888-964-6681",
            "fax_number": "339-686-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5960 FAIRVIEW RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282100202",
            "telephone_number": "888-964-6681",
            "fax_number": "888-662-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAXTER J. SMITH JR., OD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-17",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BAXTER",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "857-255-0486",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909846",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthDrive Eye Care Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Francisco Eduardo Bautista Vitiello, M.D.
• Gifty Bawre, MSN, FNP-C
• Jennifer Carmack Baxley, PA
• Jessica Baxley
• Jessica Baxley, M.D.
• Catherine Ann Baxter, NP
• Christopher Baxter
• Felicia Baxter
• Mendy Annette Baxter, MS OTRL
• Shanay Adrianna Baxter

• Optometrist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.