Ty Smith, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3691 Issued in TN

Practice address

50 N Main St Ste 102
Collierville, TN 38017-2605

Phone

(901) 484-7017

NPI assigned

Jul 26, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS, TN2 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

Specialty

Optometry

Education

Southern College of Optometry, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Obrien Vision Center, P.a.Group PAC ID 6002990983, 5 clinicians

Charleston Vision Center PAGroup PAC ID 2466692777, 3 clinicians

Byhalia Vision Center LLCGroup PAC ID 7517297591, 5 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.

• Byhalia Vision Center LLC

  • Optometrist
  • Byhalia, MS
  • NPI 1952965022
  Medicare reassignment Care Compare group NPD
• Charleston Vision Center PA

  • Optometrist
  • Charleston, MS
  • NPI 1932440138
  Medicare reassignment Care Compare group NPD
• Obrien Vision Center, P.a.

  • Optometrist
  • Southaven, MS
  • NPI 1518046234
  Medicare reassignment Care Compare group NPD
• Eyecare East, PLLC

  • Optometrist
  • Germantown, TN
  • NPI 1700131752
  Medicare reassignment NPD
• Square Eyecare, PLLC.

  • Optometrist
  • Collierville, TN
  • NPI 1770163305
  Medicare reassignment NPD

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1992282529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N MAIN ST",
            "address_2": "STE 102",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172605",
            "telephone_number": "662-772-5882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MAIN ST STE 102",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172605",
            "telephone_number": "901-484-7017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3161 Highway 64 Ste 500",
            "address_purpose": "LOCATION",
            "city": "Eads",
            "state": "TN",
            "postal_code": "380283370",
            "country_code": "US",
            "telephone_number": "901-465-3130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6450 Poplar Ave Ste 117",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381194882",
            "country_code": "US",
            "telephone_number": "901-797-9008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9031 Valley Crest Ln",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381387829",
            "country_code": "US",
            "telephone_number": "901-757-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "975",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Slavens, DC
• Sleep Source Tennessee
• Lovell Bernard Smith Jr., MD
• Morgan Smith, MS, CCC-SLP
• Tamra L Smith, M.D.
• Kate Weeden Snyder, FNP-C
• Carol Solo, CST
• James David Solomon, DPH
• Sos Serving Our Seniors LLC
• Southeastern Medical LLC

• Optometrist in Collierville, TN
• Providers in Collierville, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.