Samuel Smith, COA

Primary specialty

Ophthalmic Technician/TechnologistTaxonomy code 156FX1100X

License

COA

Practice address

1501 San Pedro Dr SE
Albuquerque, NM 87108-5153

Phone

(505) 265-1711

NPI assigned

Jul 25, 2021

Sex

Male

Sole proprietor

No

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)

Not enrolled

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

{
    "created_epoch": "1627171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627171200000",
    "number": "1306519541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 BACUS AVE APT 9",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813014161",
            "telephone_number": "971-258-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SAN PEDRO DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871085153",
            "telephone_number": "505-265-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SAMUEL",
        "credential": "COA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-25",
        "last_updated": "2021-07-25",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1100X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": null,
            "license": "COA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebekah Marie Smith, M.D.
• Richard B Smith, M.D,
• Robert Thomas Smith, D.N.
• Russell Smith
• Russell Curtis Smith
• Sandra A Smith, DDS
• Sandra Iveth Smith
• Season Smith
• Seth Smith
• Sheldon Smith

• Ophthalmic Technician/Technologist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Ophthalmic Technician/Technologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2021; 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.