HEALTHDRIVE EYE CARE GROUP (BAXTER J. SMITH JR., OD, PA) NPI 1003011446

Optometrist in Charlotte, NC

NPI 1003011446 Organization Optometrist

About HEALTHDRIVE EYE CARE GROUP (BAXTER J. SMITH JR., OD, PA)

Healthdrive Eye Care Group (baxter J. Smith Jr., Od, Pa) is a provider established in Charlotte, North Carolina specializing in optometrist. The NPI number of Healthdrive Eye Care Group (baxter J. Smith Jr., Od, Pa) is 1003011446 and was assigned on June 2007. The practitioner's primary taxonomy code is 152W00000X with license number 858 (NC). The provider is registered as an organization and their NPI record was last updated July 2021. Healthdrive Eye Care Group (baxter J. Smith Jr., Od, Pa) operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Healthdrive Eye Care Group. The authorized official of this NPI record is Dr. Baxter J. Smith Jr. Od (President)

NPI

1003011446

Provider NameHEALTHDRIVE EYE CARE GROUP (BAXTER J. SMITH JR., OD, PA)
Provider Location Address5960 FAIRVIEW RD STE 300 CHARLOTTE, NC 28210
Provider Mailing Address100 CROSSING BLVD STE 300 FRAMINGHAM, MA 01702
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameHEALTHDRIVE EYE CARE GROUP
Other Name TypeDoing Business As (3)
Enumeration Date06-17-2007
Last Update Date07-14-2021


Primary Taxonomy

Taxonomy Code152W00000X
ClassificationOptometrist
TypeEye and Vision Services Providers
License No.858
License StateNC
Taxonomy DescriptionDoctors 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.

Business Address

HEALTHDRIVE EYE CARE GROUP
5960 FAIRVIEW RD STE 300
CHARLOTTE, NC
ZIP 28210
Phone: (888) 964-6681
Fax: (888) 662-0859

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Mailing Address

HEALTHDRIVE EYE CARE GROUP
100 CROSSING BLVD STE 300
FRAMINGHAM, MA
ZIP 01702
Phone: (888) 964-6681
Fax: (339) 686-2561



Authorized Official

Authorized Official NameDR. BAXTER J. SMITH JR. OD
Authorized Official TitlePRESIDENT
Authorized Official Phone(857) 255-0486

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
8909846MEDICAID (05)NC

Other Providers at the same location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1629662598HEALTHDRIVE PODIATRY GROUP NC, PC
Organization
Podiatrist5960 FAIRVIEW RD STE 300
CHARLOTTE, NC 28210
(888) 964-6681
1073871737DR. ROSHNI GANDHI PATEL D.P.M.
Individual
Podiatrist (Foot & Ankle Surgery)5960 FAIRVIEW RD STE 300
CHARLOTTE, NC 28210
(888) 964-6681
1689750648DR. BAXTER J SMITH JR. OD
Individual
Optometrist5960 FAIRVIEW RD STE 300
CHARLOTTE, NC 28210
(888) 964-6681
1922670876 EYRA TAMAKLOE OD
Individual
Student in an Organized Health Care Education/Training Program5960 FAIRVIEW RD STE 300
CHARLOTTE, NC 28210
(888) 964-6681

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.