Individual provider Active NPI

Abigail Lorraine Smith Kendall, OD

  • Pediatric Optometrist
  • Columbia, MO
National Provider Identifier
1417579194
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric OptometristTaxonomy code 152WP0200X
License
2021021137 Issued in MO
Practice address
3215 Wingate CT
Columbia, MO 65201-7214
Phone
(573) 884-3937
Fax
(573) 884-4868
NPI assigned
May 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2021021137 MO
Optometrist 152W00000X S-E63-TA-B74 AL
Pediatric Optometrist 152WP0200X 2021021137 MO Primary

Addresses

Primary practice location

3215 Wingate CT
Columbia, MO 65201-7214

Mailing address

PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300

Other names 1

  • Abigail Lorraine Smith Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200604000777 AL Practitioner - Optometry 9234550989 Reassigns benefits to 1 organization
I20210927001909 MO Practitioner - OptometryPractitioner - Other (Physician) 9234550989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3215 Wingate CT
102 Eye Institute East
Columbia, MO 65201-7689
Phone (573) 882-8920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S-E63-TA-B74ALMDOptometrist
2021021137MOMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Alabama at Birmingham Optometrist CurrentSince Jun 22, 2020 Accepting new patients
University of Alabama at Birmingham CurrentSince Jun 22, 2020 Accepting new patients
Curators of the University of Missouri CurrentSince Sep 20, 2021 Accepting new patients
The Curators of the University of Missouri CurrentSince Sep 20, 2021 Accepting new patients
University of Alabama at Birmingham Current Accepting new patients

Locations

1716 University Blvd
Birmingham, AL 35233
Phone (205) 934-3899

1716 University Blvd
Birmingham, AL 35294

1716 University Blvd
#G80A
Birmingham, AL 35233
Phone (205) 934-4748

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

3215 Wingate Ct
Ste 102
Columbia, MO 65201
Phone (573) 882-8920

3215 Wingate Ct
Columbia, MO 65201
Phone (573) 882-8920

Organizations & group practices 5

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": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1417579194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 WINGATE CT",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017214",
            "telephone_number": "573-884-3937",
            "fax_number": "573-884-4868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH KENDALL",
        "first_name": "ABIGAIL",
        "middle_name": "LORRAINE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-15",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2021021137",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-E63-TA-B74",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MO",
            "license": "2021021137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABIGAIL",
            "last_name": "SMITH",
            "middle_name": "LORRAINE",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.