Elven Conrad Smith III, O.D.

Primary specialty

Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X

License

1267 Issued in NC

Practice address

720 E US Highway 74
Ste a
Rockingham, NC 28379-7524

Phone

(910) 205-2020

Fax

(910) 582-2030

NPI assigned

Jun 2, 2006

Last updated

Mar 17, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NC

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

University of Houston - College of Optometry, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fox Eye Care GroupGroup PAC ID 6002888559, 7 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fox Eye Care Group

  • Optometrist
  • Greensboro, NC
  • NPI 1215994371
  Medicare reassignment Care Compare group NPD
• Smith Optometric PLLC

  • Low Vision Rehabilitation Optometrist
  • Rockingham, NC
  • NPI 1790145423
  Medicare reassignment NPD Authorized official
• Elven C Smith III

  dba Smith Optometric

  • Optometrist
  • Rockingham, NC
  • NPI 1902215551
  NPD (past) Authorized official
• Ma RM JH Inc

  dba Hardwick Vision Center

  • Optician
  • Rockingham, NC
  • NPI 1326318890
  NPD
• Mark C Mitchum OD

  • Optometrist
  • Sanford, NC
  • NPI 1174564538
  NPD (past)

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1215974548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 E BROAD AVE",
            "address_2": "STE A",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283794908",
            "telephone_number": "910-997-7737",
            "fax_number": "910-997-7058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E US HIGHWAY 74",
            "address_2": "STE A",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283797524",
            "telephone_number": "910-205-2020",
            "fax_number": "910-582-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ELVEN",
        "middle_name": "CONRAD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1267",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "NC",
            "license": "1267",
            "primary": true
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "SC",
            "license": "1182",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "1267",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE#",
            "identifier": "1267",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "1182",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909835",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Bryce Simmons Futrell
• Joel Thomas Simmons, PMHNP-BC, RN
• Arlester Simpson Jr.
• Paul Gulsharan Singh, MD
• Smith Optometric PLLC
• Jennifer Denine Smith
• Khymaya Tionne Smith, RBT
• Molly Peyton Smith, MSW, LCSWA
• Southeastern Health Care Services, LLC
• Southeastern United Care, LLC

• Low Vision Rehabilitation Optometrist in Rockingham, NC
• Providers in Rockingham, NC by specialty
• Low Vision Rehabilitation Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; 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.