Jacquelyn Elizabeth Smith, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1851 Issued in KS

Practice address

1122 N Topeka St
Wichita, KS 67214-2810

Phone

(316) 866-2000

Fax

(316) 866-2084

NPI assigned

Jun 11, 2009

Last updated

Nov 26, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

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

University of Missouri, Kansas City, School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gracemed Health Clinic IncGroup PAC ID 9830098185, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gracemed Health Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1184691693
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1568699064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 N WOODLAWN ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672083648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 N TOPEKA ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672142810",
            "telephone_number": "316-866-2000",
            "fax_number": "316-866-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACQUELYN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-11",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emalee Elizabeth Smith, MD
• Emily Smith, DPT
• Geneva Smith, CNA/CMA/RA
• Gregory Barton Smith, PH.D.
• Haley Bennison Smith, PA
• James A.M. Smith, DO
• James Anthony Smith, LCMFT
• Jamie L Smith
• Jeffrey Dean Smith, ATC
• Jeffrey Scott Smith, DDS

• Optometrist in Wichita, KS
• Providers in Wichita, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; 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.