Organization Active NPI

Smith Optometry LLC

  • Optometrist
  • St George, UT
National Provider Identifier
1669995445
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SMITH OPTOMETRY LLC
Practice address
599 S Mall Dr SPC K-1
St George, UT 84790-1258
Phone
(435) 359-2020
NPI assigned
Jul 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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

Authorized official

Name
Mrs. Shonee Smith Smith
Title
Office Manager
Phone
(435) 650-4103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

599 S Mall Dr SPC K-1
St George, UT 84790-1258

Mailing address

25 W Telegraph St Unit 906
Washington, UT 84780-6036

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180123002743 UT Part B Supplier - Clinic/Group Practice 3476812280 Receives reassigned benefits from 3 practitioners
Practice locations: St George, UT

National Provider Directory

National Provider Directory

Locations

599 S Mall Dr
Ste K1
St George, UT 84790
Phone (435) 359-2020

Practitioners & affiliated clinicians

Practitioners 3

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": "1500854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516665600000",
    "number": "1669995445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 W TELEGRAPH ST UNIT 906",
            "city": "WASHINGTON",
            "state": "UT",
            "postal_code": "847806036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "599 S MALL DR SPC K-1",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847901258",
            "telephone_number": "435-359-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH OPTOMETRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-24",
        "last_updated": "2018-01-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SHONEE",
        "authorized_official_middle_name": "SMITH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "435-650-4103",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.