Individual provider Active NPI

Douglas J McGuire, OD

  • Optometrist
  • Saint Louis, MO
National Provider Identifier
1013998707
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T-03075 Issued in MO
Practice address
5496 Baumgartner Rd
S.105
Saint Louis, MO 63129-2834
Phone
(314) 487-2600
Fax
(314) 487-7135
NPI assigned
Nov 9, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T-03075 MO Primary

Addresses

Primary practice location

5496 Baumgartner Rd
S.105
Saint Louis, MO 63129-2834

Mailing address

5496 Baumgartner Rd
S.105
Saint Louis, MO 63129-2834
Phone (314) 487-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T-03075MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Desoto Vision Care LLC Optometrist CurrentSince Oct 20, 2024 Accepting new patients
Prange Riley Optometrists, P.C. Optometrist PastSince Mar 15, 2000 Accepting new patients

Locations

126 S Main St
De Soto, MO 63020
Phone (636) 586-5406

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013998707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5496 BAUMGARTNER RD",
            "address_2": "S.105",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631292834",
            "telephone_number": "314-487-2600",
            "fax_number": "314-487-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5496 BAUMGARTNER RD",
            "address_2": "S.105",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631292834",
            "telephone_number": "314-487-2600",
            "fax_number": "314-487-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGUIRE",
        "first_name": "DOUGLAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T-03075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.