Individual provider Active NPI

Lauren Alexandra Smith, O.D.

  • Optometrist
  • Midlothian, VA
National Provider Identifier
1841676095
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618002643 Issued in VA
Practice address
5919 Harbour Park Dr
Midlothian, VA 23112
Phone
(804) 739-8646
Fax
(804) 739-9651
NPI assigned
Aug 10, 2015
Last updated
Jun 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1985DT KY
Optometrist 152W00000X 0618002643 VA Primary

Addresses

Primary practice location

5919 Harbour Park Dr
Midlothian, VA 23112

Mailing address

5919 Harbour Park Dr
Midlothian, VA 23112-2163
Phone (804) 739-8646

Other identifiers 1

IdentifierTypeStateIssuer
0618002643OtherVASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20181219003556 VA Practitioner - Optometry 3476868704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5919 Harbour Park Dr
Midlothian, VA 23112-2163
Phone (804) 739-8646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1985DTKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ky Doctors of Optometry, PLLC Optometrist CurrentSince May 6, 2017 Accepting new patients
Visionary Optometry, PLLC Optometrist CurrentSince Sep 22, 2018 Accepting new patients
Scott E Bailey OD PC Optometrist CurrentSince Sep 22, 2018 Accepting new patients
Senior Health Services LLC PastSince Aug 1, 2015 Accepting new patients
Ky Doctors of Optometry, PLLC Optometrist Past Accepting new patients

Locations

5919 Harbour Park Dr
Midlothian, VA 23112
Phone (804) 739-8646

Organizations & group practices 5

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": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1841676095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5919 HARBOUR PARK DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122163",
            "telephone_number": "804-739-8646",
            "fax_number": "804-739-9651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5919 HARBOUR PARK DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "23112",
            "telephone_number": "804-739-8646",
            "fax_number": "804-739-9651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LAUREN",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-10",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1985DT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0618002643",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.