Emily Smith, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-009974 Issued in IL

Practice address

1200 W Deyoung St
Marion, IL 62959-4437

Phone

(618) 993-5686

Fax

(618) 997-6250

NPI assigned

Jul 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christian County VisionaryGroup PAC ID 3971005067, 4 clinicians

DRS Sehy and Jones Optometrists PCGroup PAC ID 0941388722, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• IL PPO Downstate
• IL HMO C-SNP
• devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9

Interoperability endpoints

• Direct secure messaging: emily.smith@direct.revolutionehr.com

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.

• Christian County Visionary

  • Optometrist
  • Pana, IL
  • NPI 1508526864
  Medicare reassignment Care Compare group NPD
• DRS. Sehy and Jones Optometrists, P.C.

  • Optometrist
  • Effingham, IL
  • NPI 1003026204
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1013117159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 W SPRINGFIELD RD",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625681213",
            "telephone_number": "217-287-2020",
            "fax_number": "217-824-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W DEYOUNG ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629594437",
            "telephone_number": "618-993-5686",
            "fax_number": "618-997-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EMILY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC NUMBER",
            "identifier": "0814870032",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00454765, CB9582",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC NUMBER",
            "identifier": "0814870028",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC NUMBER",
            "identifier": "0814870001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "IL9974",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC NUMBER",
            "identifier": "0814870027",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009974",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC NUMBER",
            "identifier": "0814870029",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "135537",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Sisk
• Sleep Medicine Associates, LLC.
• Amelia Marie Smith, RN
• Andrea Smith, RN
• Calli Marie Smith, LMT
• Garrett William Smith
• Jennifer Smith
• Jonna Lynn Smith, RPH
• Joshua Smith, PA-C
• Julie Ann Smith

• Optometrist in Marion, IL
• Providers in Marion, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.