Individual provider Active NPI

Kris Edward Smith, O.D.

  • Optometrist
  • Vero Beach, FL
National Provider Identifier
1578624813
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC2122 Issued in FL
Practice address
792 S US Highway 1
Vero Beach, FL 32962-4701
Phone
(772) 770-2020
Fax
(772) 770-4617
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC2122 FL Primary

Addresses

Primary practice location

792 S US Highway 1
Vero Beach, FL 32962-4701

Mailing address

792 S US Highway 1
Vero Beach, FL 32962-4701
Phone (772) 770-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20100923001565 FL Practitioner - Optometry 4789700022 Receives reassigned benefits from 1 practitioner
Practice locations: Vero Beach, FL

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

792 S US
Suite 1
Vero Beach, FL 32962-4701

792 S US Hwy 1
Vero Beach, FL 32962-4701

792S US Hwy 1
Vero Beach, FL 32962-4701
Phone (772) 770-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578624813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "792 S US HIGHWAY 1",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329624701",
            "telephone_number": "772-770-2020",
            "fax_number": "772-770-4617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "792 S US HIGHWAY 1",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329624701",
            "telephone_number": "772-770-2020",
            "fax_number": "772-770-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRIS",
        "middle_name": "EDWARD",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.