Individual provider Active NPI

David P Smith, O.D.

  • Optometrist
  • Henderson, NV
National Provider Identifier
1861484347
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0128 Issued in NV
Practice address
1485 W Warm Springs Rd
Henderson, NV 89014-7632
Phone
(702) 433-1102
Fax
(702) 433-1916
NPI assigned
Aug 19, 2005
Last updated
Jul 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0128 NV Primary

Addresses

Primary practice location

1485 W Warm Springs Rd
Henderson, NV 89014-7632

Mailing address

1485 W Warm Springs Rd
Henderson, NV 89014-7632
Phone (702) 433-1102

Other identifiers 1

IdentifierTypeStateIssuer
002502575MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0128NVMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Doyle & Rastegar-Lari, PLLC Optometrist CurrentSince Sep 5, 2023 Accepting new patients

Locations

1485 W Warm Springs Rd
Ste 106
Henderson, NV 89014
Phone (702) 433-1102

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": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1861484347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 W WARM SPRINGS RD",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890147632",
            "telephone_number": "702-433-1102",
            "fax_number": "702-433-1916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 W WARM SPRINGS RD",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890147632",
            "telephone_number": "702-433-1102",
            "fax_number": "702-433-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DAVID",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "0128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002502575",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; 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.