Individual provider Active NPI

Courtney Smith, OD

  • Optometrist
  • Kokomo, IN
National Provider Identifier
1669200507
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004534A Issued in IN
Practice address
1601 W Lincoln Rd
Kokomo, IN 46902-3275
Phone
(765) 453-5696
NPI assigned
Jul 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18004534A IN Primary

Addresses

Primary practice location

1601 W Lincoln Rd
Kokomo, IN 46902-3275

Mailing address

17404 Fetzer CT
Westfield, IN 46062-8019
Phone (317) 225-7603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20240822004263 IN Practitioner - Optometry 6103365093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Eye Consultants PCGroup PAC ID 2961399217, 71 clinicians

Practice addresses (Care Compare)

510 Saraina Rd
Shelbyville, IN 46176-1892
Phone (317) 398-9793

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Eye Consultants, P.C. CurrentSince Jul 1, 2024 Accepting new patients
Midwest Eye Consultants, P.C. Current Accepting new patients
Midwest Eye Consultants, PC Optometrist CurrentSince Jul 1, 2024 Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients

Locations

2750 Central Ave
#53
Columbus, IN 47201
Phone (812) 372-4463

825 N Lincoln St
#12
Greensburg, IN 47240
Phone (812) 663-7222

5319 S Emerson Ave
Indianapolis, IN 46237
Phone (317) 755-2254

1601 W Lincoln Rd
Kokomo, IN 46902
Phone (765) 453-5696

301 J St
Laporte, IN 46350
Phone (219) 326-9569

620 E 11th St
Rushville, IN 46173
Phone (765) 932-5553

510 Saraina Rd
#30
Shelbyville, IN 46176
Phone (317) 398-9793

215 E Jefferson St
Tipton, IN 46072
Phone (765) 675-3937

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1669200507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17404 FETZER CT",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460628019",
            "telephone_number": "317-225-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 W LINCOLN RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023275",
            "telephone_number": "765-453-5696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "COURTNEY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004534A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.