Kathryn Jeannine Smoltino

Primary specialty

OpticianTaxonomy code 156FX1800X

License

1063 Issued in SC

Practice address

115 E Church St
Leesville, SC 29070-7595

Phone

(803) 532-5339

NPI assigned

Jul 25, 2022

Sex

Female

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1558097428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E CHURCH ST",
            "city": "LEESVILLE",
            "state": "SC",
            "postal_code": "290707595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E CHURCH ST",
            "city": "LEESVILLE",
            "state": "SC",
            "postal_code": "290707595",
            "telephone_number": "803-532-5339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLTINO",
        "first_name": "KATHRYN",
        "middle_name": "JEANNINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-25",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "SC",
            "license": "1063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC OPTICIANS LICENSE",
            "identifier": "1063",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjsmolt.s04420.us@wal-mart.com",
            "affiliation": "N",
            "address_1": "115 E Church St",
            "city": "Leesville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "290707595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Leesville, SC
• Optician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.