Individual provider Active NPI

James Smyth, O.D.

  • Optometrist
  • Vernon, CT
National Provider Identifier
1013079706
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2019 Issued in CT
Practice address
458 Talcottville Rd
Vernon, CT 06066-4052
Phone
(860) 875-6156
Fax
(860) 872-3828
NPI assigned
Dec 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2019 CT Primary

Addresses

Primary practice location

458 Talcottville Rd
Vernon, CT 06066-4052

Mailing address

458 Talcottville Rd
Vernon, CT 06066-4052
Phone (860) 875-6156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2019CTMDPhysical Rehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyeball Optical Inc Past Accepting new patients
Kelly Family Eyecare, LLC Optometrist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013079706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "458 TALCOTTVILLE RD",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664052",
            "telephone_number": "860-875-6156",
            "fax_number": "860-872-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "458 TALCOTTVILLE RD",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664052",
            "telephone_number": "860-875-6156",
            "fax_number": "860-872-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMYTH",
        "first_name": "JAMES",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.