Cameron Fredrick Boboth, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2766 Issued in AR

Practice address

1021 S Waldron Rd
Fort Smith, AR 72903

Phone

(479) 478-8860

Fax

(479) 478-8860

NPI assigned

Jul 25, 2017

Last updated

Mar 5, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AR, WA, AZ3 enrollments

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 3

Specialty

Optometry

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Boboth Vision Clinic Wa PLLCGroup PAC ID 7517207756, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Boboth Vision Clinic, Wa PLLC

  dba Boboth Vision Clinic

  • Optometrist
  • Grandview, WA
  • NPI 1699256008
  Medicare reassignment Care Compare group NPD
• Arkansas Vision Development Center PA

  • Vision Therapy Optometrist
  • Fort Smith, AR
  • NPI 1942326244
  Medicare reassignment NPD

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1043733744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 S WALDRON RD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 S WALDRON RD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "72903",
            "telephone_number": "479-478-8860",
            "fax_number": "479-478-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBOTH",
        "first_name": "CAMERON",
        "middle_name": "FREDRICK",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-25",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2766",
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "AR",
            "license": "2766",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "AR",
            "license": "2766",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liam Bloebaum, DO
• Shelby Blossom-Ferguson
• Bluesprig Pediatrics
• Bly Thomas Mental Health Counseling Organization Inc
• Board Certified Plastic Surgeon, P.a. (Raymond C. Goodman Jr, M.D.)
• Majusha Boddu, M.B.B.S
• Bodiford Eye Institute, PA (Bodiford Eye Center)
• Scott Bodkin
• Stacy Lynn Boggs
• Taylor Bogle

• Optometrist in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.