Chad P Smith, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

787 Issued in MS

Practice address

211 N Whitworth Ave
Brookhaven, MS 39601-3051

Phone

(601) 833-4431

Fax

(601) 833-1007

NPI assigned

Aug 6, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Southern College of Optometry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr. Chuck Barnes, PAGroup PAC ID 7315007069, 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 and National Provider Directory roles.

• Dr. Chuck Barnes, PA

  • Optometrist
  • McComb, MS
  • NPI 1326298704
  Medicare reassignment Care Compare group NPD Authorized official
• Smith Eye Care PC

  • Optometrist
  • Brookhaven, MS
  • NPI 1003070533
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1174714133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N WHITWORTH AVE",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013051",
            "telephone_number": "601-833-4431",
            "fax_number": "601-833-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N WHITWORTH AVE",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013051",
            "telephone_number": "601-833-4431",
            "fax_number": "601-833-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHAD",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Michelle Smallwood, PTA
• Smith Eye Care PC
• Amy M Smith, CFNP
• Antonette Smith
• Cecilia Smith, COTA
• David Anthony Smith, MSN, PMHNP-BC
• Hollie Christina Smith, BSN, RN
• Jennifer D Smith, FNP
• Jonathan Smith, FNP
• Joseph Reid Smith, ACNPC-AG

• Optometrist in Brookhaven, MS
• Providers in Brookhaven, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; 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.