Madison Nicole Smith, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT.007080 Issued in OH

Practice address

1073 Pray Blvd
Waterville, OH 43566-8712

Phone

(567) 952-2020

NPI assigned

Aug 26, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Lolo Creek Vision

  • Health Service Clinic/Center
  • Missoula, MT
  • NPI 1497576938
  NPD Authorized official
• Advanced Eye Care MD PC

  • Ophthalmology Physician
  • Southfield, MI
  • NPI 1164599437
  NPD (past)

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672012800000",
    "number": "1801515366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1073 PRAY BLVD # 11",
            "city": "WATERVILLE",
            "state": "OH",
            "postal_code": "435668712",
            "telephone_number": "567-952-2020",
            "fax_number": "567-952-2142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1073 PRAY BLVD",
            "city": "WATERVILLE",
            "state": "OH",
            "postal_code": "435668712",
            "telephone_number": "567-952-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MADISON",
        "middle_name": "NICOLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-26",
        "last_updated": "2022-12-26",
        "certification_date": "2022-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.007080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jon Tyler Schwanz, D.C.
• Jon W Schwanz, D.C.
• Sarah Jane Schyllander
• Jennifer W Seagert
• Rebecca L Siders, D.O.
• Smithpsych LLC
• Thomas Eric Sperling, DDS
• Talia Mary-Lou Spillett, BSN, RN
• Shay Lynn Spitler, OTR/LOH
• Donna Nichter Sprunger, PMHNP-BC

• Optometrist in Waterville, OH
• Providers in Waterville, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.