Kelsey Deborah Smith, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2361 Issued in SC

Practice address

717 Old Trolley Rd Ste 3
Summerville, SC 29485-5287

Phone

(843) 873-1889

NPI assigned

Jun 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Optometry

Education

New England College of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Care Associates of SC LLCGroup PAC ID 4587998802, 63 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Eye Care Associates of SC LLC

  • Optometrist
  • Chapin, SC
  • NPI 1679046569
  Medicare reassignment Care Compare group NPD
• F Mason Smith

  • Optometrist
  • Mt Pleasant, SC
  • NPI 1477795722
  NPD (past)
• America'S Best Contacts & Eyeglasses

  • Eyewear Supplier
  • Colorado Springs, CO
  • NPI 1407888951
  NPD (past)

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1750905964",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "24 SATO STREET",
            "city": "WHITBY",
            "state": "ONTARIO",
            "postal_code": "L1R2E6"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 OLD TROLLEY RD STE 3",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855287",
            "telephone_number": "843-873-1889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1075 N Academy Blvd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809094401",
            "country_code": "US",
            "telephone_number": "719-597-4001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELSEY",
        "middle_name": "DEBORAH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-03",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003591",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Smith, CRNA
• Jennifer Lusetta Smith
• Jody Kay Smith, NP
• Joshua Charles Smith
• Katherine Anne M Smith, MPT
• Lacey Smith, RN
• Larissa L Smith, PT
• Larkin C Smith, MS, LAT, ATC, CSCS
• Laura McLaurin Smith, CCC-SLP
• Lindsay Bach Smith, M.S., CCC-SLP

• Optometrist in Summerville, SC
• Providers in Summerville, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.