Jill Denise Smith Radkowiec, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2010020657 Issued in MO

Practice address

202 E North Street
California, MO 65018

Phone

(573) 796-2222

Fax

(573) 796-4184

NPI assigned

Jul 8, 2010

Last updated

Jul 8, 2010By the provider in NPPES

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 names 1

• Jill Denise Smith Former name

Medicare fee-for-service enrollment

Enrolled in MO

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

University of Missouri St Louis - School of Optometry, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Columbia Eye Consultants OptometryGroup PAC ID 2769574714, 14 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jill.radkowiec@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Columbia Eye Consultants Optometry

  • Optometrist
  • Columbia, MO
  • NPI 1346396033
  Medicare reassignment Care Compare group NPD
• Paige Hedgpath OD,PC

  dba Eyes On Missouri

  • Optometrist
  • Jefferson City, MO
  • NPI 1962644732
  Medicare reassignment NPD
• International Eyecare Center LLC

  • Optometrist
  • Quincy, IL
  • NPI 1760405047

  MO

  Medicare reassignment NPD
• Central Missouri Dermatology Associates, LLP

  • Dermatology Physician
  • Columbia, MO
  • NPI 1447669932
  NPD
• International Eyecare Center, Inc

  • Optometrist
  • Fulton, MO
  • NPI 1235455320
  NPD
• Paige Hedgpath Odpc

  dba Eyes On Missouri

  • Optometrist
  • Columbia, MO
  • NPI 1669530887
  NPD
• International Eyecare Center Inc

  dba Malbar Vision

  • Optometrist
  • Omaha, NE
  • NPI 1386825610
  NPD
• Columbia Eyewear

  • Optician
  • Columbia, MO
  • NPI 1720134513
  NPD (past)

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1114239092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 246",
            "city": "CALIFORNIA",
            "state": "MO",
            "postal_code": "65018",
            "telephone_number": "573-796-2222",
            "fax_number": "573-796-4184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E NORTH STREET",
            "city": "CALIFORNIA",
            "state": "MO",
            "postal_code": "65018",
            "telephone_number": "573-796-2222",
            "fax_number": "573-796-4184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADKOWIEC",
        "first_name": "JILL",
        "middle_name": "DENISE SMITH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2010020657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "SMITH",
            "middle_name": "DENISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• N & R of California, Inc. (California Care Center)
• Michelle Ann Nolph, ANP
• Pamida Stores Operating Co LLC (Pamida Pharmacy 853)
• Pamida Stores Operating Co LLC (Pamida Pharmacy 853)
• Breanna Rae Pruitt
• Nicole E. Raithel
• Glenn R. Stenquist, D.D.S.
• Cole Edward Vanderfeltz, OD
• Donald J Vanderfeltz, O. D.
• Kennedy Jean Volkart, DC

• Optometrist in California, MO
• Providers in California, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; 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.