Individual provider Active NPI

Janna Suzette Smith, OD

  • Optometrist
  • Dickson, TN
National Provider Identifier
1083607279
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2172 Issued in TN
Practice address
110 Mathis Drive
Suite 108
Dickson, TN 37055
Phone
(615) 446-8089
Fax
(615) 441-3135
NPI assigned
Aug 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2172 TN Primary

Addresses

Primary practice location

110 Mathis Drive
Suite 108
Dickson, TN 37055

Mailing address

110 Mathis Dr
Suite 108
Dickson, TN 37055-2000
Phone (615) 446-8089

Other identifiers 3

IdentifierTypeStateIssuer
1083607279OtherTNINDIVIDUAL NPI #
3944408MedicaidTN
2172OtherTNOD

Other names 1

  • Janna Suzette Zbozien Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20050928000122 TN Practitioner - Optometry 6406880988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dickson Optical PCGroup PAC ID 0547392524, 3 clinicians

Practice addresses (Care Compare)

110 Mathis Dr
Suite 108
Dickson, TN 37055-2077
Phone (615) 446-8089

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2172TNMDOptometrist

Organizations & group practices 1

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1083607279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MATHIS DR",
            "address_2": "SUITE 108",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552000",
            "telephone_number": "615-446-8089",
            "fax_number": "615-441-3135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MATHIS DRIVE",
            "address_2": "SUITE 108",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "37055",
            "telephone_number": "615-446-8089",
            "fax_number": "615-441-3135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JANNA",
        "middle_name": "SUZETTE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI #",
            "identifier": "1083607279",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3944408",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OD",
            "identifier": "2172",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANNA",
            "last_name": "ZBOZIEN",
            "middle_name": "SUZETTE",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dickson, TN

Sources for this page

Verify at the official NPI Registry.