Tony Shawn Smith, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1391DT Issued in KY

Practice address

1225 Paris Rd
Mayfield, KY 42066-4989

Phone

(270) 251-2020

Fax

(270) 247-8652

NPI assigned

Aug 2, 2005

Last updated

Jun 16, 2022By the provider in NPPES

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

Enrolled in KY

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, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1487655437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 PARIS RD",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420664989",
            "telephone_number": "270-251-2020",
            "fax_number": "270-247-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 PARIS RD",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420664989",
            "telephone_number": "270-251-2020",
            "fax_number": "270-247-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TONY",
        "middle_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1391DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77013910",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lucinda Joy Sirls, RN
• Six Dimensions (Triana Institute)
• Joseph C. Slaughter, MD
• Camilla Smith, LPCA
• Patricia Webb Smith, ARNP
• SNH Derby Tenant LLC (Morningside of Mayfield)
• Jenniffer Marie Solivan Albino, MD
• Megan Speed, APRN
• Emily Spencer, OTR/L
• Spine and Vascular Exposures LLC

• Optometrist in Mayfield, KY
• Providers in Mayfield, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; 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.