Willie Darrell Smith, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

490100002985 Issued in MI

Practice address

1357 S Main St
Adrian, MI 49221-4352

Phone

(517) 263-0424

Fax

(517) 263-6379

NPI assigned

Feb 27, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

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 and National Provider Directory roles.

• West Point Optical Group

  • Optometrist
  • Novi, MI
  • NPI 1831548890
  Medicare reassignment

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1437286713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1357 S MAIN ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492214352",
            "telephone_number": "517-263-0424",
            "fax_number": "517-263-6379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1357 S MAIN ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492214352",
            "telephone_number": "517-263-0424",
            "fax_number": "517-263-6379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WILLIE",
        "middle_name": "DARRELL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "490100002985",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MI",
            "license": "490100002985",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "MI",
            "license": "490100002985",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "MI",
            "license": "490100002985",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4248362",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PH15592",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla B Smith, PT, DPT
• Kelsey Leeann Smith
• Samantha Emily Smith
• Scott Raymond Smith, D.D.S.
• Wayne A Smith, MD
• Melody Smolik
• Steven M Smolinski, M.D., PH.D.
• Rick Allen Snow, OD
• Aimee Marie Kirchner Snyder, MA, LLPC
• Sarah Snyder, LMT

• Optometrist in Adrian, MI
• Providers in Adrian, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; 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.