Individual provider Active NPI

Kelly A Smith, O.D.

  • Optometrist
  • Panama City, FL
National Provider Identifier
1881619955
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4065 Issued in FL
Practice address
2500 W 23Rd St
Panama City, FL 32405-2349
Phone
(850) 763-2020
Fax
(850) 784-3539
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S-B14-TA-705 AL
Optometrist 152W00000X OPC4065 FL Primary

Addresses

Primary practice location

2500 W 23Rd St
Panama City, FL 32405-2349

Mailing address

2800 Ross Clark Cir
Dothan, AL 36301-2040
Phone (334) 793-2211

Other practice location 1

607 Boll Weevil Cir Ste C
Enterprise, AL 36330-2733
Phone (334) 347-6599

Other identifiers 3

IdentifierTypeStateIssuer
240878MedicaidAL
28556OtherFLBLUE CROSS & BLUE SHIELD
P0030826OtherFLRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051013000393 FL Practitioner - Optometry 8921023482 Reassigns benefits to 1 organization
I20190612004027 AL Practitioner - Optometry 8921023482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Partners PCGroup PAC ID 8123016334, 31 clinicians

Practice addresses (Care Compare)

2800 Ross Clark Cir
Dothan, AL 36301-2040
Phone (334) 793-2211

4340 Lafayette St
Marianna, FL 32446-2916
Phone (850) 482-2336

607 Boll Weevil Cir
Suite C
Enterprise, AL 36330-2733
Phone (334) 793-2211

Merit-based Incentive Payment System (MIPS)

Final score
84.59 of 100Reported as group
Quality
87.13
Promoting interoperability
95
Improvement activities
40
Cost
65.66

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC4065FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Partners PC CurrentSince May 11, 2019 Accepting new patients
Eye Partners, PC Optometrist CurrentSince May 11, 2019 Accepting new patients
Eye Partners PC Optometrist CurrentSince Apr 1, 2022 Accepting new patients

Locations

2800 Ross Clark Cir
Dothan, AL 36301
Phone (334) 793-3411

151 W Main St
Dothan, AL 36301
Phone (334) 793-2633

607 Boll Weevil Cir
#C
Enterprise, AL 36330
Phone (334) 347-6599

607 Boll Weevil Cir
Enterprise, AL 36330

4340 Lafayette St
Marianna, FL 32446
Phone (850) 482-2336

2500 W 23rd St
Panama City, FL 32405
Phone (850) 784-3921

2401 State Ave
Panama City, FL 32405
Phone (850) 747-1818

Interoperability endpoints

  • Direct secure messaging: kelly.smith.p1@direct.ecs.nextgenshare.com

Organizations & group practices 3

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1881619955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363012040",
            "telephone_number": "334-793-2211",
            "fax_number": "334-793-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324052349",
            "telephone_number": "850-763-2020",
            "fax_number": "850-784-3539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "607 Boll Weevil Cir Ste C",
            "address_purpose": "LOCATION",
            "city": "Enterprise",
            "state": "AL",
            "postal_code": "363302733",
            "country_code": "US",
            "telephone_number": "334-347-6599",
            "fax_number": "334-417-0190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-B14-TA-705",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240878",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "28556",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P0030826",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.