Dan Martin Smyly, OPTICIAN

Primary specialty

OpticianTaxonomy code 156FX1800X

License

983 Issued in GA

Practice address

4765 Memorial Dr
Decatur, GA 30032-1417

Phone

(404) 296-2307

Fax

(404) 296-0850

NPI assigned

Mar 31, 2007

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

State licenses

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.

• Mary N, Brunner, LLC

  • Optometrist
  • Decatur, GA
  • NPI 1851763916
  NPD (past)
• Barrows Family Eyecare

  • Optometrist
  • Bluffton, SC
  • NPI 1518181429
  NPD (past)

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

{
    "created_epoch": "1175299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801916812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4765 MEMORIAL DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300321417",
            "telephone_number": "404-296-2307",
            "fax_number": "404-296-0850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4765 MEMORIAL DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300321417",
            "telephone_number": "404-296-2307",
            "fax_number": "404-296-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMYLY",
        "first_name": "DAN",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "GA",
            "license": "983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optician in Decatur, GA
• Providers in Decatur, GA by specialty
• Optician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.