Organization Active NPI

Scott Smith, OD PLLC

Doing business as Family Eye Care Center

  • Optometrist
  • Lawrenceburg, KY
National Provider Identifier
1184828576
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1390DT Issued in KY
Legal business name
SCOTT SMITH, OD PLLC
Doing business as
Family Eye Care Center
Practice address
500 W Broadway St
Lawrenceburg, KY 40342-1306
Phone
(502) 839-5113
Fax
(502) 839-9831
NPI assigned
Jun 12, 2007
Last updated
Sep 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Authorized official

Name
Scott Smith, O.D.
Title
Member
Phone
(502) 839-5113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1390DT KY Primary

Addresses

Primary practice location

500 W Broadway St
Lawrenceburg, KY 40342-1306

Mailing address

PO Box 168
Lawrenceburg, KY 40342-0168
Phone (502) 839-5113

Other identifiers 6

IdentifierTypeStateIssuer
000000217614OtherKYANTHEM BC BS
62308OtherCIGNA
1169150OtherCHA
5089659OtherKYAETNA
DD0334OtherKYRAILROAD MEDICARE
77013902MedicaidKY

Other names 1

  • Family Eye Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041013000646 KY Part B Supplier - Clinic/Group Practice 5294795373 Receives reassigned benefits from 1 practitioner
Practice locations: Lawrenceburg, KY

National Provider Directory

National Provider Directory

Locations

1100 Glensboro Rd
Ste 8
Lawrenceburg, KY 40342
Phone (502) 604-1129

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1184828576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 168",
            "city": "LAWRENCEBURG",
            "state": "KY",
            "postal_code": "403420168",
            "telephone_number": "502-839-5113",
            "fax_number": "502-839-9831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST",
            "city": "LAWRENCEBURG",
            "state": "KY",
            "postal_code": "403421306",
            "telephone_number": "502-839-5113",
            "fax_number": "502-839-9831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT SMITH, OD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "502-839-5113",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1390DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS",
            "identifier": "000000217614",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "62308",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHA",
            "identifier": "1169150",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5089659",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD0334",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77013902",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Eye Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawrenceburg, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.