Active NPI
James Smallwood, OPTICIAN
- Optician
- Pikeville, KY
National Provider Identifier
1427101245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 509
- Practice address
- 3469 N Mayo TRL
Pikeville, KY 41501-3265 - Phone
- (606) 437-7702
- Fax
- (606) 437-2307
- NPI assigned
- Jan 18, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 509 | KY | Primary |
Addresses
Primary practice location
3469 N Mayo TRL
Pikeville, KY 41501-3265
Mailing address
3469 N Mayo TRL
Pikeville, KY 41501-3265
Phone (606) 437-7702
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52000106 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 509 | KY | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437436800000",
"number": "1427101245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3469 N MAYO TRL",
"city": "PIKEVILLE",
"state": "KY",
"postal_code": "415013265",
"telephone_number": "606-437-7702",
"fax_number": "606-437-2307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3469 N MAYO TRL",
"city": "PIKEVILLE",
"state": "KY",
"postal_code": "415013265",
"telephone_number": "606-437-7702",
"fax_number": "606-437-2307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMALLWOOD",
"first_name": "JAMES",
"credential": "OPTICIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-18",
"last_updated": "2015-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "KY",
"license": "509",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "52000106",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pikeville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.