Organization Active NPI

R. Kirk Smithhart, O.D. Inc.

  • Optometrist
  • Jackson, MS
National Provider Identifier
1174889067
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
476 Issued in MS
Legal business name
R. KIRK SMITHHART, O.D. INC.
Practice address
500K E Woodrow Wilson Ave
Jackson, MS 39216-4538
Phone
(601) 366-4221
Fax
(601) 362-3153
NPI assigned
Apr 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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

Authorized official

Name
Dr. R Kirk Smithhart, O.D.
Title
Doctor
Phone
(601) 366-4221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 476 MS Primary

Addresses

Primary practice location

500K E Woodrow Wilson Ave
Jackson, MS 39216-4538

Mailing address

500K E Woodrow Wilson Ave
Jackson, MS 39216-4538
Phone (601) 366-4221

Other identifiers 1

IdentifierTypeStateIssuer
00087892MedicaidMS

National Provider Directory

National Provider Directory

Locations

500K E Woodrow Wilson Ave
Jackson, MS 39216
Phone (601) 366-4221

500 E Woodrow Wilson Ave
Jackson, MS 39216
Phone (601) 366-4221

NPI Registry JSON

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1174889067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500K E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164538",
            "telephone_number": "601-366-4221",
            "fax_number": "601-362-3153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500K E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164538",
            "telephone_number": "601-366-4221",
            "fax_number": "601-362-3153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R. KIRK SMITHHART, O.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-05",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "SMITHHART",
        "authorized_official_first_name": "R",
        "authorized_official_middle_name": "KIRK",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "601-366-4221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00087892",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.