Active NPI
M T Aldrich, OD
- Optometrist
- Saint Joseph, MO
National Provider Identifier
1023050911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TO2103
- Practice address
- 1309 Village Dr
Saint Joseph, MO 64506-2457 - Phone
- (816) 279-2339
- Fax
- (816) 279-0110
- NPI assigned
- Jun 12, 2006
- Last updated
- Feb 10, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TO2103 | MO | Primary |
Addresses
Primary practice location
1309 Village Dr
Saint Joseph, MO 64506-2457
Mailing address
1309 Village Dr
Saint Joseph, MO 64506-2457
Phone (816) 279-2339
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TO2103 | MO | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328832000000",
"number": "1023050911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1309 VILLAGE DR",
"city": "SAINT JOSEPH",
"state": "MO",
"postal_code": "645062457",
"telephone_number": "816-279-2339",
"fax_number": "816-279-0110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1309 VILLAGE DR",
"city": "SAINT JOSEPH",
"state": "MO",
"postal_code": "645062457",
"telephone_number": "816-279-2339",
"fax_number": "816-279-0110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALDRICH",
"first_name": "M",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2012-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "TO2103",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Joseph, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.