Mark Allen Smith, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00001519 Issued in WA

Practice address

15821 Sr 525
Langley, WA 98260-9780

Phone

(360) 321-4779

Fax

(360) 321-4782

NPI assigned

Sep 20, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1437144037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15821 SR 525",
            "city": "LANGLEY",
            "state": "WA",
            "postal_code": "982609780",
            "telephone_number": "360-321-4779",
            "fax_number": "360-321-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15821 SR 525",
            "city": "LANGLEY",
            "state": "WA",
            "postal_code": "982609780",
            "telephone_number": "360-321-4779",
            "fax_number": "360-321-4782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2080307",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Saratoga Enterprises Inc (Langley Drug)
• Saratoga Enterprises Inc
• Saratoga Speech Therapy LLC
• Donna Brand Selig, RN
• Judith Skenazy, PH.D.
• Jennifer Sousa, LMHC
• South Whidbey Fire EMS
• South Whidbey School District
• Madison Nicole Spencer, LMT
• Stillpoint Psychiatry

• Optometrist in Langley, WA
• Providers in Langley, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; 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.