Smith Eye Care PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

449 Issued in MS

Legal business name

SMITH EYE CARE PC

Practice address

211 N Whitworth Ave
Brookhaven, MS 39601-3051

Phone

(601) 833-4431

Fax

(601) 833-1007

NPI assigned

Jul 14, 2008

Organization subpart

No

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

Authorized official

Name

Chad P Smith, ODNPI 1174714133

Title

Owner

Phone

(601) 833-4431

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chad P Smith, O.D.

  • Optometrist
  • Brookhaven, MS
  • NPI 1174714133
  Medicare reassignment NPD Authorized official
• Mark P Smith, OD

  • Optometrist
  • Brookhaven, MS
  • NPI 1952497679
  Medicare reassignment NPD

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625097600000",
    "number": "1003070533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N WHITWORTH AVE",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013051",
            "telephone_number": "601-833-4431",
            "fax_number": "601-833-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N WHITWORTH AVE",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013051",
            "telephone_number": "601-833-4431",
            "fax_number": "601-833-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-14",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-833-4431",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00089225",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://smitheyecare.itrust.io",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "211 N Whitworth Ave",
            "city": "Brookhaven",
            "state": "MS",
            "country_code": "US",
            "postal_code": "396013051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Silver Cross Home
• Simmons Eye Clinic, LLC.
• Eugene Ainsworth Simmons Jr., M.D.
• Timothy Slay, PT
• Kelly Michelle Smallwood, PTA
• Amy M Smith, CFNP
• Antonette Smith
• Cecilia Smith, COTA
• Chad P Smith, O.D.
• David Anthony Smith, MSN, PMHNP-BC

• Optometrist in Brookhaven, MS
• Providers in Brookhaven, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.