Golden Thane Smith, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-992 Issued in ID

Practice address

500 S Utah Ave
Idaho Falls, ID 83402-3305

Phone

(208) 528-8643

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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 UT

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles (3 of 5)

Locations

Networks

• UT PPO
• UT PPO D-SNP

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.

• Standard Optical Co

  • Optometrist
  • Orem, UT
  • NPI 1093816548
  Medicare reassignment NPD
• Standard Optical Co

  • Optometrist
  • Salt Lake City, UT
  • NPI 1174624787
  NPD
• Standard Optical Company

  • Optometrist
  • West Point, UT
  • NPI 1659958841
  NPD

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1154432938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S UTAH AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023305",
            "telephone_number": "208-528-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S UTAH AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023305",
            "telephone_number": "208-528-8643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 E 1300 S",
            "address_purpose": "LOCATION",
            "city": "Richfield",
            "state": "UT",
            "postal_code": "847013122",
            "country_code": "US",
            "telephone_number": "435-893-8478",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1120 W Pioneer Blvd",
            "address_purpose": "LOCATION",
            "city": "Mesquite",
            "state": "NV",
            "postal_code": "890278864",
            "country_code": "US",
            "telephone_number": "208-709-0905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GOLDEN",
        "middle_name": "THANE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "1040",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "11319935-9934",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Philip Wiser Smith, D.O.
• E. Wade Smith, LCSW, LPC
• Emily Smith, LMSW
• Emily Ricks Smith, LCSW-34678
• Ethan Smith, LMSW
• Haleigh Smith
• Heather Michele Smith, PTA
• Joshua Michael Smith, M.D.
• Kabel Smith, FNP
• Kevin Samora Smith

• Optometrist in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.