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

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Amanda Smith Optometry, PLLC
726 N Locust Ave, Lawrenceburg, TN 38464-2874 · (931) 762-7226
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignment
Participating since Aug 31, 2020

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
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

IdentifierTypeStateIssuer
Q058467MedicaidTN

Other names

  • Envision Eyecare and Eyewear Doing business as

Other providers in Lawrenceburg, TN

All providers in Lawrenceburg, TN · Optometrist in Tennessee

Sources for this page

Verify at the official NPI Registry.