Charles M Smith III, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT000892 Issued in GA

Practice address

415 W Crawford St
Dalton, GA 30720-4267

Phone

(706) 278-6113

Fax

(706) 226-5741

NPI assigned

Aug 5, 2006

Last updated

Aug 24, 2007By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Shim Vision Group Inc

  dba Dalton Optometry

  • Optometrist
  • Dalton, GA
  • NPI 1902471477
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187913600000",
    "number": "1235148875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 969",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307220969",
            "telephone_number": "706-278-6113",
            "fax_number": "706-226-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W CRAWFORD ST",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307204267",
            "telephone_number": "706-278-6113",
            "fax_number": "706-226-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARLES",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT000892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smile Center of Dalton LLC
• Ashley Smith
• Benjamin Smith, D.O.
• Brandon Alan Smith, M.D.
• Breianna Smith, M.S. CCC-SLP
• Courtney Hammons Smith
• Dennis Smith, LPC
• Jennifer M Smith, FNP
• Julie Ann Smith
• Karah Freeman Smith, PA-C

• Optometrist in Dalton, GA
• Providers in Dalton, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2007; 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.