Gray Robert Smith, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

OPC3661 Issued in FL

Practice address

2250 E Highway 50
Suite 1
Clermont, FL 34711-6052

Phone

(352) 243-5349

Fax

(352) 243-8358

NPI assigned

May 18, 2007

Last updated

Feb 7, 2012By 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

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Dr. Gray R. Smith, Inc.

  dba South Lake Optical

  • Corneal and Contact Management Optometrist
  • Clermont, FL
  • NPI 1588805444
  Authorized official Same address or phone

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1417165028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 E HIGHWAY 50",
            "address_2": "SUITE 1",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116052",
            "telephone_number": "352-243-5349",
            "fax_number": "352-243-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 E HIGHWAY 50",
            "address_2": "SUITE 1",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116052",
            "telephone_number": "352-243-5349",
            "fax_number": "352-243-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GRAY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "OPC3661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smiles on Hampton LLC
• Claudia A Smith Todd, RN
• Michael Smith-Cummings, PH.D.
• Amber Smith
• Ashley Marie Smith, PTA
• Kim R Smith, LMHC, LPC
• Lynette Weeks Smith, HCBS PROVIDER
• Madison Elizabeth Smith
• Matthew L Smith, M.D.
• Michelle Ann Smith, CBHT

• Corneal and Contact Management Optometrist in Clermont, FL
• Providers in Clermont, FL by specialty
• Corneal and Contact Management Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.