DRS Steven and Brenda Smoke OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

04901003315 Issued in MI

Legal business name

DRS STEVEN AND BRENDA SMOKE OD PC

Practice address

18301 US Highway 12
New Buffalo, MI 49117-8848

Phone

(269) 469-6331

Fax

(269) 469-6848

NPI assigned

Jan 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Brenda D Smoke, O.D.

Title

Vice President

Phone

(269) 469-6331

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Smoke Family Vision Center Doing business as

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251072000000",
    "number": "1215089230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18301 US HIGHWAY 12",
            "city": "NEW BUFFALO",
            "state": "MI",
            "postal_code": "491178848",
            "telephone_number": "269-469-6331",
            "fax_number": "269-469-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18301 US HIGHWAY 12",
            "city": "NEW BUFFALO",
            "state": "MI",
            "postal_code": "491178848",
            "telephone_number": "269-469-6331",
            "fax_number": "269-469-6848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS STEVEN AND BRENDA SMOKE OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2009-08-24",
        "status": "A",
        "authorized_official_last_name": "SMOKE",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "269-469-6331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "04901003315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP PIN",
            "identifier": "900A10020",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "0P18480",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smoke Family Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amelia Anne Danesi
• David P. Kelsey, M.D. Kelsey Medical Center
• Allison Ann Dent
• Diane Giancaspro LCSW LLC
• Nicole Donnelly
• Melissa Ann Forker
• Piper Friend
• Ashley Gage, CPHT
• Rebecca Lynn Gardner-Reilly, MPT
• Diane Giancaspro, LCSW, LMSW

• Optometrist in New Buffalo, MI
• Providers in New Buffalo, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2009; 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.