Jessica Lynne Smith, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3661-35 Issued in WI

Practice address

200 S Executive Dr Ste 101
Brookfield, WI 53005-4216

Phone

(888) 964-6681

Fax

(888) 662-0859

NPI assigned

Jun 6, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jessica Lynne Cowling Former name

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Optometry

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shoptikal LLC 192 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shoptikal LLC

  • Eyewear Supplier
  • Green Bay, WI
  • NPI 1659937159

  Optometrist, WI

  Medicare reassignment Care Compare group NPD
• Shoptikal LLC

  • Eyewear Supplier
  • Coeur D Alene, ID
  • NPI 1063078442
  Care Compare group
• Shoptikal LLC

  • Eyewear Supplier
  • Spokane, WA
  • NPI 1154987535
  Care Compare group
• Shoptikal LLC

  • Eyewear Supplier
  • West Jordan, UT
  • NPI 1407412885
  Care Compare group
• Shoptikal LLC

  • Eyewear Supplier
  • Missoula, MT
  • NPI 1417513896
  Care Compare group
• Shoptikal LLC

  • Eyewear Supplier
  • Bismarck, ND
  • NPI 1518601483
  Care Compare group
• Shoptikal LLC

  • Eyewear Supplier
  • Marquette, MI
  • NPI 1578129094
  Care Compare group
• Shoptikal LLC

  • Eyewear Supplier
  • Aberdeen, SD
  • NPI 1588220958
  Care Compare group
• Shoptikal LLC

  • Eyewear Supplier
  • Dubuque, IA
  • NPI 1588220974
  Care Compare group
• Shoptikal LLC

  • Eyewear Supplier
  • Dixon, IL
  • NPI 1699331082
  Care Compare group
• Shoptikal LLC

  • Eyewear Supplier
  • Saint Cloud, MN
  • NPI 1942866371
  Care Compare group
• Shoptikal LLC

  • Eyewear Supplier
  • Grand Island, NE
  • NPI 1952967325
  Care Compare group

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1922537653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W4271 CERESA DR",
            "city": "WEST SALEM",
            "state": "WI",
            "postal_code": "546699556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S EXECUTIVE DR STE 101",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054216",
            "telephone_number": "888-964-6681",
            "fax_number": "888-662-0859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1660 Allison St",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802146023",
            "country_code": "US",
            "telephone_number": "402-898-3232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESSICA",
        "middle_name": "LYNNE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "0003420",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3661-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "COWLING",
            "middle_name": "LYNNE",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexandra Marie Smars
• Smart Clinic Limited Practice
• Brooke Leigh Smeltzer, PTA
• Jaquica Lourdes Smith
• Jennifer Lynn Smith, PSYD, LPC
• Kyle Smith, MSOM
• Lindsay Marie Smith
• Mary Elisabeth Smith, BA
• Tammy Smith, PT
• John A. Smolik, M.D.

• All providers in Brookfield, WI
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.