Individual provider Active NPI

Janis James Smith

  • Optometrist
  • Austell, GA
National Provider Identifier
1710412473
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002990 Issued in GA
Practice address
1133 E West Connector
Austell, GA 30106-1779
Phone
(770) 863-9421
NPI assigned
May 1, 2017
Last updated
May 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002990 GA Primary

Addresses

Primary practice location

1133 E West Connector
Austell, GA 30106-1779

Mailing address

1133 E West Connector
Austell, GA 30106-1779
Phone (770) 863-9421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20191027000005 GA Practitioner - Optometry 5294067120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1133 E W Connector
Austell, GA 30106-1779
Phone (770) 863-9421

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT002990GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyeconic Family Eyecare LLC Optometrist Past Accepting new patients

Organizations & group practices 2

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": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1710412473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 E WEST CONNECTOR",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061779",
            "telephone_number": "770-863-9421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 E WEST CONNECTOR",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061779",
            "telephone_number": "770-863-9421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JANIS",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.