Alan Richard Smith, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

ODP-1060 Issued in ID

Practice address

2100 12TH Ave Rd
Nampa, ID 83686-6441

Phone

(208) 467-5293

Fax

(208) 467-5359

NPI assigned

Aug 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942316054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2583 N MIRANDA AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429051",
            "telephone_number": "208-895-0831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 12TH AVE RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866441",
            "telephone_number": "208-467-5293",
            "fax_number": "208-467-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ALAN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "ID",
            "license": "ODP-1060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "000010148906",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "15392",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "V5228",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Angela Smith, LMSW-38273
• Carson Smith
• Corry Smith
• Diana Christine Smith
• John Ervin Smith, PA-C

• Corneal and Contact Management Optometrist in Nampa, ID
• Providers in Nampa, ID by specialty
• Corneal and Contact Management Optometrist in Idaho

• 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.