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  7. NPI Record 1376237412

MRS. SUSAN MARIE SMITH LDO
Complete NPI Record 1376237412
Technician/Technologist - Optician in Middleburg, FL

NPI Status: Active since June 02, 2023

Contact Information

1580 BRANAN FIELD RD
MIDDLEBURG, FL
ZIP 32068
Phone: (904) 214-9102
Fax: (904) 214-9054

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Name Prefix Text
  7. Provider Credential Text
  8. Provider First Line Business Mailing Address
  9. Provider Business Mailing Address City Name
  10. Provider Business Mailing Address State Name
  11. Provider Business Mailing Address Postal Code
  12. Provider Business Mailing Address Country Code If outside U S
  13. Provider Business Mailing Address Telephone Number
  14. Provider First Line Business Practice Location Address
  15. Provider Business Practice Location Address City Name
  16. Provider Business Practice Location Address State Name
  17. Provider Business Practice Location Address Postal Code
  18. Provider Business Practice Location Address Country Code If outside U S
  19. Provider Business Practice Location Address Telephone Number
  20. Provider Business Practice Location Address Fax Number
  21. Provider Enumeration Date
  22. Last Update Date
  23. Provider Gender Code
  24. Healthcare Provider Taxonomy Code 1
  25. Healthcare Provider Primary Taxonomy Switch 1
  26. Is Sole Proprietor
  27. Healthcare Provider Taxonomy Group 1
  28. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1376237412. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1376237412
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. 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 (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: SUSAN
The first name of the provider, if the provider is an individual.
Provider Middle Name: MARIE
The middle name of the provider, if the provider is an individual.
Provider Name Prefix Text: MRS.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Credential Text: LDO
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address: 3310 WILDERNESS CIR
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: MIDDLEBURG
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: FL
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 320684128
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 9047148101
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address: 1580 BRANAN FIELD RD
The first line 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 Business Practice Location Address City Name: MIDDLEBURG
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: FL
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 320688427
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 9042149102
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 9042149054
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/2/2023
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 6/2/2023
The date that a record was last updated or changed.
Provider Gender Code: F
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 156FX1800X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Sole Proprietor: Y
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP
NPI Certification Date: 6/2/2023