NPIMap

Organization Active NPI

Kevin Smith OD and Associates Inc

Doing business as South Tampa Eye Site

  • Corneal and Contact Management Optometrist
  • Tampa, FL
National Provider Identifier
1023275468
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
Legal business name
KEVIN SMITH OD AND ASSOCIATES INC
Doing business as
South Tampa Eye Site
Practice address
4117 Henderson Blvd
Tampa, FL 33629-5749
Phone
(813) 207-8984
NPI assigned
May 22, 2008
Last updated
May 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Authorized official

Name
Dr. Kevin L. Smith, O.D.NPI 1518945179
Title
President
Phone
(813) 207-8984

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU
Optometrist 152W00000X NU
Corneal and Contact Management Optometrist 152WC0802X NU Primary
Low Vision Rehabilitation Optometrist 152WL0500X NU

Addresses

Primary practice location

4117 Henderson Blvd
Tampa, FL 33629-5749

Mailing address

4117 Henderson Blvd
Tampa, FL 33629-5749
Phone (813) 207-8984

Other identifiers 3

IdentifierTypeStateIssuer
5929060001OtherFLPTAN
620814200MedicaidFL
OPC3456OtherFLSTATE OF FLORIDA

Other names 1

  • SOUTH TAMPA EYE SITE Doing business as

National Provider Directory

National Provider Directory

Locations

4117 Henderson Blvd
Tampa, FL 33629
Phone (813) 207-8984

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1023275468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4117 HENDERSON BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295749",
            "telephone_number": "813-207-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4117 HENDERSON BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295749",
            "telephone_number": "813-207-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN SMITH OD AND ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-207-8984",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "5929060001",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620814200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA",
            "identifier": "OPC3456",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH TAMPA EYE SITE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.