Individual provider Active NPI

Stephanie Ivor-Smith, OD

  • Optometrist
  • Englewood, CO
National Provider Identifier
1174971733
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.000000000 Issued in CO
Practice address
10520 El Diente CT
Englewood, CO 80112-2656
Phone
(720) 524-1001
Fax
(303) 756-0898
NPI assigned
May 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.000000000 CO Primary

Addresses

Primary practice location

10520 El Diente CT
Englewood, CO 80112-2656

Mailing address

3900 E Mexico Ave
Ste 102
Denver, CO 80210-3940
Phone (720) 524-1001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.000000000COMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1174971733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 E MEXICO AVE",
            "address_2": "STE 102",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802103940",
            "telephone_number": "720-524-1001",
            "fax_number": "303-756-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10520 EL DIENTE CT",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801122656",
            "telephone_number": "720-524-1001",
            "fax_number": "303-756-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVOR-SMITH",
        "first_name": "STEPHANIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-24",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.000000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; 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.