Amanda Smith Optometry, PLLC
Organization Active NPI Optometrist · Lawrenceburg, TN
NPI 1467070656 · NPPES record last updated May 6, 2021
Key facts
- NPI
- 1467070656
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- AMANDA SMITH OPTOMETRY, PLLC
- Practice address
- 726 N Locust Ave Ste 2D
Lawrenceburg, TN 38464-2874 - Phone
- (931) 762-7226
- Fax
- (931) 762-1133
- NPI assigned
- Jul 14, 2020
- Organization subpart
- No
Authorized official
- Name
- Mrs. Debra Gordon
- Title
- Billing Manager
- Phone
- (931) 762-7226
Practitioners 1
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Amanda Smith Optometry, PLLC |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201123003347 | TN | Part B Supplier - Clinic/Group Practice | 3971914961 |
Receives reassigned benefits from 1 practitioner Practice locations: Lawrenceburg, TN |
| O20210723000206 | TN | DME Supplier - Physician - Optometrist | 3971914961 | Practice locations: Lawrenceburg, TN |
National Provider Directory
Locations
726 N Locust Ave
Ste 2D
Lawrenceburg, TN 38464
Phone (931) 762-7226
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
726 N Locust Ave Ste 2D
Lawrenceburg, TN 38464-2874
Mailing address
726 N Locust Ave Ste 2D
Lawrenceburg, TN 38464-2874
Phone (931) 762-7226
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q058467 | Medicaid | TN |
Other names
- Envision Eyecare and Eyewear
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All providers in Lawrenceburg, TN · Optometrist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.