Jacob Connor Smith, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

S-E40 Issued in AL

Practice address

110 College St Ste B
Athens, AL 35611-2714

Phone

(256) 233-5454

NPI assigned

Jun 5, 2020

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

Enrolled in AL

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

Specialty

Optometry

Education

Southern College of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Drake Eye Center IncGroup PAC ID 0446467898, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Drake Eye Center Inc

  • Optometrist
  • Hartselle, AL
  • NPI 1073692265
  Medicare reassignment Care Compare group NPD
• Star Optometry Al, LLC

  dba InFocus Eyecare

  • Optometrist
  • Athens, AL
  • NPI 1528841954
  Medicare reassignment NPD
• Drake Eye Center Inc

  • Optometrist
  • Decatur, AL
  • NPI 1699661496
  NPD
• Pathway Eye Athens

  • Optometrist
  • Athens, AL
  • NPI 1205009750
  NPD

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591315200000",
    "number": "1427672450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20189 MARY ELLA ST",
            "city": "TANNER",
            "state": "AL",
            "postal_code": "356713645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 COLLEGE ST STE B",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356112714",
            "telephone_number": "256-233-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACOB",
        "middle_name": "CONNOR",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-05",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-E40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard E Sipes, DDS
• Bradee Aiyer Sittason, DMD
• Anna Skipworth
• Heather Moon Small, O.D.
• April Smith, MA
• Jessica Smith
• Kelsey Dee Smith, PTA
• Lindsey T Smith, CRNP
• Lydia Smith
• Rylee Smith, M.S., CCC-SLP

• Optometrist in Athens, AL
• Providers in Athens, AL by specialty
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.