Mark P Smith, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

449 Issued in MS

Practice address

211 North Whitworth Ave
Brookhaven, MS 39601

Phone

(601) 833-4431

Fax

(601) 833-1007

NPI assigned

Oct 4, 2006

Last updated

Sep 20, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Smith Eye Care PC

  • Optometrist
  • Brookhaven, MS
  • NPI 1003070533
  Medicare reassignment NPD

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1952497679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 NORTH WHITWORTH AVE",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "39601",
            "telephone_number": "601-833-4431",
            "fax_number": "601-833-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 NORTH WHITWORTH AVE",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "39601",
            "telephone_number": "601-833-4431",
            "fax_number": "601-833-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARK",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "512G700288",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09125722",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Reid Smith, ACNPC-AG
• Kariean Smith, LPC-S
• Kia C Smith, M.REL, PCMHT
• Lesleye L Smith, CCC-A
• Manerva Angelica Smith
• Melanie Smith
• Prentiss Lee Smith Sr., MD
• Kelli Snider
• South Mississippi Home Health Inc - Region II (Deaconess HomeCare)
• South Mississippi Home Health, Inc. (Deaconess Hospice)

• Optometrist in Brookhaven, MS
• Providers in Brookhaven, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.