Stephen Patrick Smith, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004840 Issued in MI

Practice address

3468 28TH St SE
Kentwood, MI 49512-1602

Phone

(616) 974-8981

NPI assigned

Oct 1, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Carlson Eye Care, LLC

  • Optometrist
  • Grand Rapids, MI
  • NPI 1215605134
  NPD

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1588067706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3468 28TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495121602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3468 28TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495121602",
            "telephone_number": "616-974-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHEN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-01",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MI",
            "license": "4901004840",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "MI",
            "license": "4901004840",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George J Sloma, D.C.
• Cienna Jalyn Smith, RBT
• Elizabeth Ruth Smith, LMSW
• Isabelle Smith
• Paige Mallory Louise Smith
• Taylor Smith
• Social Work Concierge
• Solutionschronicpain PLLC
• Taylor Anne Sorensen-Cavasos
• Yevette Soule

• Optometrist in Kentwood, MI
• Providers in Kentwood, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.