J. KYLE SMITH (NPI# 1184674152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184674152 |
| Entity Type | Individual |
| Full Name | J. KYLE SMITH |
| Credential | O.D. |
| Practice Address |
450 N Mcpherson St Fort Bragg CA 95437-3314 |
| Practice Telephone | 7079645927 |
| Practice Fax Number | 7079646533 |
| Mailing Telephone | 7079645927 |
| Mailing Fax Number | 7079646533 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2008-12-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 11804 | CA | Eye and Vision Services Providers |
| N | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
11804 | CA | Eye and Vision Services Providers |
| N | 152WL0500X |
Optometrist Specialization: Low Vision Rehabilitation |
11804 | CA | Eye and Vision Services Providers |
| N | 152WP0200X |
Optometrist Specialization: Pediatrics |
11804 | CA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RRMCARE | 410048777 | 01 |
| CA | SD0118040 | 05 | |
| CA | RR MEDICARE | RR3046 | 01 |
| CA | 5187135 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740549013 | J. Steven Smith | Dentist | 1820 West Lincoln, Bozeman, MT 59715 | 2012-05-08 |
| 1518162635 | J. Anthony Smith | Dentist | 306 Ne Blake St Ste 3, Bentonville, AR 72712-5328 | 2007-06-19 |
| 1043446297 | J. Joshua Smith | Dentist | 2180 E 4500 S, Suite #250, Salt Lake City, UT 84117-4434 | 2009-06-02 |
| Street Address |
450 N MCPHERSON ST |
| City | FORT BRAGG |
| State | CA |
| Zip Code | 95437-3314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447366364 | Lindsay Aden Wansbury | Counselor | 450 N Mcpherson St, Fort Bragg, CA 95437 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902357437 | Mendocino Coast Hospitality Center | Community/Behavioral Health | 137 E. Oak Street, Fort Bragg, CA 95437 | 2016-10-19 |
| 1144604570 | Erin Paul | Community Health Worker | 474 South Franklin Street, Fort Bragg, CA 95437 | 2015-07-15 |
| 1508125790 | Joel Macgregor Green | Marriage & Family Therapist | 331- G Redwood Ave., Fort Bragg, CA 95437 | 2012-05-09 |
| 1013244102 | Jenna Glasscock | Counselor | 331 E Redwood Ave, Ste E, Fort Bragg, CA 95437 | 2009-11-10 |
| 1770819641 | Patrick Lenaghan | Emergency Medicine | 707 River Dr, Fort Bragg, CA 95437 | 2009-10-27 |
| 1043455827 | M. Lee Baker | Dentist | 890 River Dr, Fort Bragg, CA 95437 | 2008-12-09 |
| 1528250495 | Christine Anne Samas | Social Worker | 656a Harrison St., Fort Bragg, CA 95437 | 2007-08-15 |
| 1083822811 | Katharine L. White | Marriage & Family Therapist | 137 E Oak Street, Fort Bragg, CA 95437 | 2007-05-17 |
| 1053525873 | Marty Christine Johnson | Marriage & Family Therapist | 331 E. Redwood Ave, Fort Bragg, CA 95437 | 2007-05-10 |
| 1528114741 | Kate Teresa Donohue | Psychologist | 19201 Noyo Acres Dr, Fort Bragg, CA 95437 | 2007-01-29 |
| Find all providers in zip 95437 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730698010 | Stephen Thomas Tipton | Optometrist | 1605 Reilly Rd, Fort Bragg, NC 28307-5001 | 2017-09-29 |
| 1487184131 | Winston Posvar | Optometrist | 3908 Longstreet Bldg 3-4303, Fort Bragg, NC 28310-0001 | 2017-06-15 |
| 1841588076 | Frances Marie Silva | Optometrist | Wamc Mcxc Dofm Os, 2817 Reilly Rd. Stop A, Fort Bragg, NC 28310-0001 | 2011-07-21 |
| 1912213976 | John Patrick O'brien | Optometrist | Optometry Family Health Services, Womack Army Medical Center, Bldg 4-2817, Fort Bragg, NC 28310-0001 | 2010-08-27 |
| 1699936906 | Northgate Eye Center O D P A | Optometrist | 1 Fort Bragg, Fort Bragg, NC 28307-5000 | 2008-06-19 |
| 1972683464 | Elizabeth Hayes Harvey | Optometrist | 501 S Franklin St, Fort Bragg, CA 95437-5101 | 2006-10-17 |
| 1194782219 | Elias Wolfman | Optometrist | 139 Laurel St, Fort Bragg, CA 95437 | 2006-05-01 |
| 1821052168 | James Quoc Truong | Optometrist | Robinson Health Clinic, Optometry, Bldg # C1722 Tagatay Rd, Fort Bragg, NC 28310-0001 | 2006-04-13 |
| 1881688380 | Lynette Kline | Optometrist | 510 Cypress St, Ste A, Fort Bragg, CA 95437-5411 | 2005-09-12 |
| 1831799063 | Samantha Macchio | Optometrist | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2020-10-27 |
| Find all providers in FORT BRAGG | ||||
| City | FORT BRAGG |
| Zip Code | 95437 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.