Individual provider Active NPI

Laura Elizabeth Wooten, OD

  • Optometrist
  • Conway, AR
National Provider Identifier
1275029258
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2778 Issued in AR
Practice address
924 Main St
Conway, AR 72032-5424
Phone
(501) 327-4444
Fax
(501) 327-3962
NPI assigned
Jul 2, 2018
Last updated
Mar 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2778 AR Primary

Addresses

Primary practice location

924 Main St
Conway, AR 72032-5424

Mailing address

924 Main St
Conway, AR 72032-5424
Phone (501) 327-4444

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20181025000278 AR Practitioner - Optometry 0648523472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Magie Smith Charton Eye Clinic PAGroup PAC ID 5092030718, 4 clinicians

Practice addresses (Care Compare)

924 Main St
Conway, AR 72032-5424
Phone (501) 327-4444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2778ARMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Magie Smith Charton Eye Clinic PA CurrentSince Mar 3, 2025 Accepting new patients

Locations

924 Main St
Conway, AR 72032
Phone (501) 327-4444

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/imedicware_magiesmithchartoneye

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1275029258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 MAIN ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325424",
            "telephone_number": "501-327-4444",
            "fax_number": "501-327-3962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 MAIN ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325424",
            "telephone_number": "501-327-4444",
            "fax_number": "501-327-3962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOTEN",
        "first_name": "LAURA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.