Pec Warrenton LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PEC WARRENTON LLC

Practice address

277 W Veterans Memorial Pkwy
Warrenton, MO 63383-1067

Phone

(636) 456-2020

Fax

(636) 456-3411

NPI assigned

Jul 27, 2020

Organization subpart

No

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

Authorized official

Name

Pam Hark

Title

Billing

Phone

(618) 234-3053

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Justin Michael Kendall, OD

  • Optometrist
  • Columbia, MO
  • NPI 1932727120
  Medicare reassignment Care Compare group NPD
• Erik Michael Peyton

  • Optometrist
  • Saint Peters, MO
  • NPI 1871118992
  Medicare reassignment Care Compare group NPD
• Dirk F Massie, OD

  • Optometrist
  • Swansea, IL
  • NPI 1972510345

  MO

  Medicare reassignment Care Compare group NPD
• Amir Sahba Jalali, OD

  • Corneal and Contact Management Optometrist
  • Mexico, MO
  • NPI 1346334166
  Medicare reassignment NPD
• Marcus Andrew Cuff, O.D

  • Optometrist
  • Swansea, IL
  • NPI 1588952501

  MO

  Medicare reassignment NPD
• Jason Bradley Bechtoldt, O.D.

  • Optometrist
  • Warrenton, MO
  • NPI 1831400647
  NPD (past)
• Lawrence William Ernst, O.D.

  • Optometrist
  • Warrenton, MO
  • NPI 1972555167
  NPD (past)

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595808000000",
    "number": "1043829088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 W VETERANS MEMORIAL PKWY",
            "city": "WARRENTON",
            "state": "MO",
            "postal_code": "633831067",
            "telephone_number": "636-456-2020",
            "fax_number": "636-456-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 W VETERANS MEMORIAL PKWY",
            "city": "WARRENTON",
            "state": "MO",
            "postal_code": "633831067",
            "telephone_number": "636-456-2020",
            "fax_number": "636-456-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEC WARRENTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A",
        "authorized_official_last_name": "HARK",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "618-234-3053"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kaitlyn Pomerleau, LPC, MS

• Optometrist in Warrenton, MO
• Providers in Warrenton, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.