Organization Active NPI

David P Smith OD Apc

  • Optometrist
  • Henderson, NV
National Provider Identifier
1306169347
Registry record updated Apr 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
128 Issued in NV
Legal business name
DAVID P SMITH OD APC
Practice address
1485 W Warm Springs Rd Ste 106
Henderson, NV 89014-7632
Phone
(702) 433-1102
Fax
(702) 433-1916
NPI assigned
Mar 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2010

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

Authorized official

Name
Dr. David P Smith, OD
Title
President
Phone
(702) 433-1102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 128 NV Primary

Addresses

Primary practice location

1485 W Warm Springs Rd Ste 106
Henderson, NV 89014-7632

Mailing address

1485 W Warm Springs Rd Ste 106
Henderson, NV 89014-7632
Phone (702) 433-1102

Other identifiers 1

IdentifierTypeStateIssuer
002502575MedicaidNV

National Provider Directory

National Provider Directory

Locations

1485 W Warm Springs Rd
Ste 106
Henderson, NV 89014
Phone (702) 433-1102

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272499200000",
    "number": "1306169347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 W WARM SPRINGS RD STE 106",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890147632",
            "telephone_number": "702-433-1102",
            "fax_number": "702-433-1916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 W WARM SPRINGS RD STE 106",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890147632",
            "telephone_number": "702-433-1102",
            "fax_number": "702-433-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID P SMITH OD APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-04",
        "last_updated": "2010-04-29",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-433-1102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NV",
            "license": "128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002502575",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2010; 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.