Individual provider Active NPI

Baxter J Smith Jr., OD

  • Optometrist
  • Charlotte, NC
National Provider Identifier
1689750648
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
858 Issued in NC
Practice address
5960 Fairview Rd Ste 300
Charlotte, NC 28210-0202
Phone
(888) 964-6681
Fax
(888) 662-0859
NPI assigned
Oct 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 858 NC Primary

Addresses

Primary practice location

5960 Fairview Rd Ste 300
Charlotte, NC 28210-0202

Mailing address

100 Crossing Blvd Ste 300
Framingham, MA 01702-5555
Phone (888) 964-6681

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20120622000202 NC Practitioner - Optometry 1951565027 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0858NCMDOccupational Therapist
858NCMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Baxter J. Smith Jr., OD, PA Optometrist CurrentSince Jul 2, 2003 Accepting new patients

Locations

100 Crossing Blvd
Ste 300
Framingham, MA 01702
Phone (857) 255-0486

9200 Glenwater Dr
Charlotte, NC 28262
Phone (704) 548-0509

5960 Fairview Rd
Ste 300
Charlotte, NC 28210
Phone (732) 806-0804

338 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 502-8570

213 Mocksville Ave
Salisbury, NC 28144
Phone (704) 636-1781

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1689750648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CROSSING BLVD STE 300",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017025555",
            "telephone_number": "888-964-6681",
            "fax_number": "339-686-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5960 FAIRVIEW RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282100202",
            "telephone_number": "888-964-6681",
            "fax_number": "888-662-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BAXTER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.